Moderate endurance training (marathon-training) – effects on immunologic and metabolic parameters in HIV-infected patients: the 42 KM cologne project

Abstract

BackgroundImproved treatment options of HIV have resulted in regular physical activities of many HIV-infected patients. However, data on effects of sports in HIV-patients are scarce.Methods21 HIV-infected persons were monitored prospectively while preparing for a marathon run. Multiple parameters with regard to immunology, quality of life and metabolism were measured at 4 time points (at baseline 1 year before the marathon run, 3 and 6 months after beginning of training, and immediately before marathon).Results13 out of 21 participants completed the marathon (12 male, 1 female; median age 42 years [27–50]; CD4 = 620/μl [146–1268]; 11 were on ART since 3.5 years [1–7]). 8 participants ceased training early. All reasons for stopping (besides one pre-existing metatarsal fracture) were not regarded as training-related (e.g. time limitation n = 3; newly diagnosed anal cancer n = 1; personal reasons/unknown n = 3).We observed a significant increase in absolute CD4-T-cells (620/μl [146–1268] vs. 745 [207–1647]; p = 0.001) with simultaneous decrease of CD4-T-cell apoptosis (53% [47–64] vs. 32% [14–42]); p < 0.01). No effects on viral load independent of ART occurred. Systolic blood pressure and cholesterol improved significantly, although moderate and normal at baseline (cholesterol 185 mg/dl [98–250] vs. 167 [106–222], p = 0.02; RRsys 125 mmHg [100–145] vs. 120 [100–140], p = 0.01). Blood count, liver enzymes, creatinine and CK remained unchanged.ConclusionsThe results of this pilot study indicated improved metabolic and immunologic parameters in HIV-infected patients undergoing moderate endurance training. Although training effects or ART cannot be ultimately separated as underlying mechanisms, we conclude that marathon training is safe for HIV-infected patients and potentially improves general health.Trial registration DRKS00011592 (retrospectively registered on February 9th 2017).

Systematic review on the effects of physical exercise on cellular immunosenescence-related markers – An update

“…Furthermore, first evidence regarding exercise-induced apoptosis after long-term exercise in young adults was provided by Schlabe et al These authors described a decrease in the percentage apoptosis of CD4+ T-cells observed in 13 HIV-infected patients after 12 months of moderate endurance training as a preparation for a marathon. There was also an increase in CD4+ cell counts, which is suggested to be related to the reduced apoptosis-associated cell death in these cells [83].…”

The immune system of athletes of different sports

“…Komano et al [15] confirmed the significance of CD86 as a marker of sufficient immunity. Schlabe et al [16] demonstrated the improvement in metabolic and immunological parameters in HIV-infected patients who have undergone moderate endurance training. The significant increase in absolute CD4 T cells was observed.…”

Physical Activity as an Adjunct Treatment for People Living with HIV?

“…[167][168][169][170][171] At this point, it can thus not be excluded that detrimental exercise modalities described as "high-intensity," "vigorous," or "forced," may also be lacking in adequate time for recovery and resolution of inflammation between sessions. A notable study by Schlabe et al (2017) 172 suggests that even marathon training, performed as "moderate endurance training" over a period of 12 months, can be safe for PLWH.…”