REVIEWS   

The Journal of Sports Medicine and Physical Fitness 1998 June;38(2):101-10

Copyright © 1998 EDIZIONI MINERVA MEDICA

lingua: Inglese

Exercise, immune function and HIV infection

Shephard R. J.

Faculty of Physical Education & Health and Department of Public Health Sciences, Faculty of Medicine, University of Toronto, and Health Studies Programme, Brock University, St. Catharines, Ontario, Canada

The impli­ca­tions of HIV infec­tion for exer­cise and ­sport are ­reviewed. HIV infec­tion ­leads to impair­ment in a num­ber of key ele­ments of ­immune func­tion, ­most obvi­ous­ly a pro­gres­sive ­decline in the num­bers of CD4+ T help­er/induc­er lym­pho­cytes. Nev­er­the­less, ­patients ­with ear­ly ­through mod­er­ate­ly ­advanced HIV-1 infec­tion can ­engage in mod­er­ate ­sport and exer­cise with­out ­risk to them­selves or oth­er par­tic­i­pants; the result­ing ­gains of aero­bic pow­er and mus­cle ­strength are sim­i­lar to ­those ­observed in ­healthy indi­vid­u­als of com­par­able ­initial fit­ness. In ful­ly devel­oped ­AIDS, the abil­ity to exer­cise may be com­pro­mised by dete­ri­ora­tions in car­di­o­res­pir­a­to­ry and neu­ro­mus­cu­lar func­tion. Giv­en the impair­ment of rest­ing ­immune func­tion, the poten­tial immu­no­sup­pres­sion ­from ­very inten­sive ­bouts of com­pet­i­tive exer­cise ­must be avoid­ed. ­Review of all pub­lished ­papers to ­date pro­vides a rel­a­tive­ly lim­it­ed ­data ­base. Dur­ing a ­bout of mod­er­ate physical activ­ity, HIV ser­o­pos­i­tive indi­vid­u­als appar­ent­ly ­have an ­impaired abil­ity to mobi­lize neu­troph­ils, NK and LAK ­cells ­into the cir­cu­la­tion. Nev­er­the­less, pro­grammes of mod­er­ate train­ing can be sus­tained with­out any ­large ­change in CD4+ ­count or CD4+/CD8+ ­ratio. In ­some stud­ies, train­ing has ­also atten­u­at­ed psy­cho­log­i­cal ­stress, pos­sibly for ­this rea­son check­ing the antic­i­pat­ed ­fall in CD4+ ­count. How­ev­er, fur­ther ­large-­scale ran­dom­ized and ­long-­term stud­ies of HIV are need­ed, com­par­ing the ther­a­peu­tic val­ue of exer­cise ­alone ­with ­that of psy­cho­ther­a­py or a com­bined pro­gramme of exer­cise and psy­cho­ther­a­py.