Aerobic-training effects on CD4 cell count and health related quality of life of people living with human immunodeficiency virus

Year 2024, Volume: 10 Issue: 1, 10 - 17, 25.03.2024

Thabo Muswere Ignatius Onyewadume

https://doi.org/10.31459/turkjkin.1375448

Abstract

This study compared the effects of 12 weeks of aerobic training against baseline data of People Living with Human Immunodeficiency Virus (PLWH) Cluster of Differentiation 4 (CD4) cell count, and Health-Related Quality of life (HRQoL) (Physical-health Component Summary (PCS) and Mental-health Component Summary (MCS)). A within-subject quasi-experimental multimethod design was used. There was purposive sampling of participants on Highly Active Antiretroviral Therapy (HAART) under Botswana Network of People Living with HIV/AIDS (BONEPWA). The 28 participants (23 females and 5 males) who met the inclusion criteria were of age 18 to 45. After 6 weeks, one female dropped out of the study. Participants were subjected to 12 weeks of aerobic training, three times a week for 60 minutes per session. The significant differences between CD4 cell count and the HRQoL variables at baseline and week 12 of the participants were compared using the paired t-test. All analysis was done using Statistical Package for the Social Sciences (SPSS) version 24.0 software. The alpha value was set at p<0.05 level of significance. The mean age and standard deviation of participants was 37.7 (± 6.84) years. Statistically significant (p< 0.05) improvements were found in MCS measures after intervention. There were no statistically significant (p>0.05) improvements in CD4 count and PCS measures after intervention. PLWH can be advised to engage in regular aerobic training 3 times a week for 60 minutes especially when on HAART. The research is relatively preliminary; therefore, there could be some replication of the study by other researchers.

Keywords

Aerobic training, CD4 cell count, highly active antiretroviral therapy (HAART), human immunodeficiency virus (HIV), health related quality of life (HRQoL)

Ethical Statement

Ethical Approval Ethical clearance was obtained from the University of Botswana Review Board, Ref: UBR/RES/IRB/SOC/GRAD/131 and the Ministry of Health of the Republic of Botswana Research Division Review Board, Ref: HPDME: 13/18/1. Permission to draw pilot study’s participants from Greater Gaborone clinics was granted by Ministry of Health Greater Gaborone District Health Management Team (Ministry of Health GGDHMT), Ref: GGDHMT 2/27 V (25) and an approval to draw participants for the major study was from Informed consent Informed consent was obtained from all individual participants included in the study BONEPWA. Data obtained from participants was kept confidential using numbers for identification.

Thanks

Acknowledgement The Department of Sports Science, the Department of Culture, Sports and Recreation, the University of Botswana Office of Research and Development, the Republic of Botswana Ministry of Health and Wellness, Botswana Network of People Living with HIV and AIDS (BONEPWA), the trainers and the volunteers, all contributed a lot to the success of this study.

References

• Algaralleh, A., Altwalbeh, D., & Al-Tarawneh, F. (2020). Health-related quality of life among persons living with HIV/AIDS in Jordan: An exploratory study. Hiv Aids (Auckl), 12, 897–907.
• Angelo, A. T., & Alemayehu, D. S. (2020). Adherence and its associated factors among adult HIV-infected patients on antiretroviral therapy in south western Ethiopia. Patient Prefer Adher, 15, 299-308.
• Asfaw, A., Ali, D., Eticha, T., Alemayehu, A., Alemayehu, M., & Kindeya, F. (2015). CD4 cell count trends after commencement of antiretroviral therapy among HIV-infected patients in Tigray, Northern Ethiopia: A retrospective gross –sectional study. PLoS One, 10(3), e0122583.
• Asogwa, E.I., Abonyi, O.S., Elom, C.O., Oduma, C.A., Umoke, C.C., Ogai, N.A., Uwaleke, C.C., & Nwimo, I.O. (2022). Comparative effects of 6-weeks progressive resistance exercise and moderate intensity aerobic exercise on CD4 count and weights of people living with HIV/AIDS in Alex-Ekwueme Federal University Teaching Hospital Ebonyi State. Medicine (Baltimore), 101(2), e28468).
• Avert | Global Information and Education on HIV and AIDS. (2021). HIV and AIDS in Botswana. Retrieved from https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/botswana
• Bento, L.C., Correia, R.P., Pedro, E. C., Alexander, A. M., Vaz, A. C., Schimidell, D., Barroso, R. S., & Bacal, N. S., (2019). Aquios CL flow cytometer performance in automated quantification of lymphocyte subpopulations. J Bras Patol Med Lab, 55(4), 378-389.
• Bonato, M., Galli, L., Passeri, L., Longo, V., Pavei, G., Bossolasco, S., Bertocchi, C., Cernuschi, M., Balconi, G., Merati, G., Lazzarin, A., La Torre, A., & Cinque, P. (2017). A pilot study of brisk walking in sedentary combination antiretroviral treatment (cART) treated patients: benefit on soluble and cell inflammatory markers. BMC Infct Dis, 17(1), 61.
• Carlson, K. A., & Winquist, J. R. (2018). An introduction to statistics: An active learning approach (2nd ed.). London, United Kindom: SAGE Publication.
• Chisati, E. M., & Vasseljen, O. (2015). Aerobic endurance in HIV-positive young adults and HIV-negative controls in Malawi. Malawi Med J, 27(1), 5–9.
• Coetzee, L. M., & Glencross, D. K. (2017). Performance verification of newly fully automated Aquios flow cytometry PanLeucogate (PLG) platform for CD4-T-lymphocyte enumeration in South Africa. PLoS One, 12(11), e0187456.
• Creswell, J.W. (2015). A concise introduction to mixed methods research. London: SAGE Publications Inc. Global AIDS monitoring. (2020.) Country progress report- Botswana. Retrieved from Unaids.org/sites/default/files/country/documents/BWA_2020_countryreport.pdf
• Gomes-Neto, M, Conceicao, C. S., Ogalha, C., & Brites, C. (2016). Aerobic capacity and health-related quality of life in adult HIV-infected patients with and without lipodystrophy. Braz J Infect Dis, 20(1), 76-80.
• Hypertension Canada. (2020). 2020-2022 hypertension highlights. Retrieved from https://hypertension.ca/wp-content/uploads/2020/10/2020-22-HT-Guidelines-E-WEB_v3b.pdf
• Ibeneme, S, C., Uwakwe, V. C., Myezwa, H., Irem, F. O., Ezenwankwo, F. E., Ajidahun, T. A., Ezuma, A.D., Okonkwo, U. P., & Fortwenge, G. (2022). Impact of exercise training on symptoms of depression, physical activity level and social participation in people living with HIV/AIDS: a systematic review and meta-analysis. BMC Infect Dis, 22, 469.
• Jain, S., Chraiti, M-N., Pittet, D., & Mclaws M-L. (2019). Blood collection guidelines for inpatients and outpatients, home-basedcare and long-term care facilities. J Hosp Infect, 104(4), 600-602.
• Laher, A. E., Richards, G. A., Paruk, F., & Venter, W. D. F. (2021). Antiretroviral therapy non-adherence among HIV-positive patients presenting to an emergency department in Johannesburg, South Africa: Associations and reasons. S Afr Med J, 111(8), 753-758.
• Luong, M.W., Ignaszewski, M., & Taylor, C. M. (2016). Stress testing: A contribution from Dr Robert A. Bruce, father of exercise cardiology. BC Med J, 58(2), 70-79.
• Maduagwu, S. M., Kaidal, A., Gashau, W., Balami. A., Ojiakor, A. C., Denue, B. A., & Kida, I. (2015). Effects of aerobic exercise on CD4 cell count and lipid profile of HIV infected persons in North Eastern Nigeria. J AIDS Clin Res, 6(10), 508.
• Mangona, L., Daca, T., Tchonga, F., Bule, O., Bhatt, N., Jani, I., Damasceno, A., & Prista, A. (2015). Effects of different types of exercise in HIV+ Mozambican women using antiretroviral therapy. Open AIDS J, 9(Suppl:M5), 89-95.
• Mbada, C. E., Onayemi, O., Ogunmoyole, Y., Johnson, O. E., & Akosile, C. O. (2013). Health related quality of life and physical functioning in people living with HIV/AIDS: A case control design. Health Qual Life Outcomes, 11, 106.
• Mendes, E. L., Andaki, A. C. R., Amorim, P. R. S., Natali, A. J., Brito, C. J., & De Paula, S. O. (2013). Physical training for HIV positive individuals submitted to HAART: Effects on anthropometric and functional parameters. Rev Bras Med Esporte, 19(1), 16-21.
• Nybo, M., Cadamuro, J., Cornes, M. P., Gómez Rioja, R., & Grankvist, K. (2018). Sample transportation - an overview. Diagnosis, 6(1), 39-43.
• Olivera, L. S., Caixeta, L. M., Martin, J. L. R., Segati, K. D., Moura, R. S., Daher, M. C., & Pinto, E.M. H. (2018). Adherence to antiretroviral therapy and correlation with adverse effects and coinfectios in people living with HIV/AIDS in the municipality of Goias state. Rev Soc Bras Med Trop, 51(4), 43644.
• Pantazis, N., Paparizos, V., Papastamopoulos, V., Metallidis, S., Antoniadou, A., Adamis, G., Psichgiou, M., Chini, M., Samabatakou, H., Chrysos, G., Sispas, N., Gogos, C., Barbunakis, E., Panagopoulos, P., Katsarou, O., & Touloumi, G. (2023). Low pre-ART CD4 count is associated with increased risk of clinical progression or death even after reaching 500 CD4 cells/μL on ART. PLoS One, 18(3), e0283648.
• Physiopedia. (2023). 12-Item Short Form Survey (SF-12). Retrieved from https://www.physio-pedia.com/12-Item_Short_Form_Survey_(SF-12)#citation
• Ramogola‐Masire, D., Poku, O., Mazhani, L., Ndwapi, N., Misra, N., Arscott‐Mills, T., Blank, L., Ho‐Foster, A., Becker, T. D., & Yang, L. (2020). Botswana’s HIV response: Policies, context, and future directions. J Community Psychol, 48(3), 1066–1070.
• Rusmussen, T. A., Ahuja, S. K., Kuwanda, L., Vjecha, M. J., hudson, F., Lal, L., Rhodes, A., Chang, J., Palmer, S., Auberson-Munderi, P., Mugwerwa, H., Wood, R., Badal-Faesen, S., Pillay, S., Mngqibisa, R., LaRosa, A., Hildago, J., Petoumenos, K., Chiu, C., Lutaakome, J., Kitonsa, J., Kabaswaga, E., Pala, P., Ganoza, C., Fisher, K., Chang, C., Lewin, S. R., & Wright, E. J. (2022). Antiretroviral initiation at ≥800 CD4+ Cells/mm3 associated with lower humman immunodeficiency virus Reservoir size. Clin Infect Dis, 75(10), 1781–1791.
• Skogen, V., Rohde, G. E., Langseth, R., Rysstad, O., Sørlie, T., & Lie, B. (2023). Factors associated with health-related quality of life in people living with HIV in Norway. Health Qual Life Outcomes, 21, 14.
• Taye, Y. (2016). Intervention of floor aerobics exercise on hematological characteristics of people living with HIV/AIDS, the case of Yeterssfa Bisrat. Miskir Assossiation, Dire Dawa, Ethiopia, 5(4), 32-40.
• United Nations Program on HIV/AIDS. (UNAIDS, 2019). Botswana extends free HIV treatment to non-citizens. Retrieved from Unaids.org/en/keywords/Botswana.
• United States Presidential Emergency Plan for AIDS Relief. (USPEPFAR, 2018). Botswana country operational plan 2018 Strategic direction summary. Retrieved from copsdata.amfar.org/SDS/2018/Botswana.pdf
• United States Presidential Emergency Plan for AIDS Relief. (USPEPFAR, 2019). Botswana country operational plan 2018 Strategic direction summary. Retrieved from copsdata.amfar.org/SDS/2019/Botswana.pdf
• United States Presidential Emergency Plan for AIDS Relief. (USPEPFAR, 2020). Botswana country operational plan COP20: Strategic direction summary. Retrieved from https://www.state.gov/wp-content/uploads/2020/07/COP-2020-Botswana-SDS-FINAL.pdf
• United States Presidential Emergency Plan for AIDS Relief. (USPEPFAR, 2022). Botswana country operational plan (COP/ROP) 2022 Strategic direction summary SDS. Retrieved from state.gov/wp-content/uploads/2022/09/Botswana-COP22-SDS.pdf
• World Health Organization. (WHO, 2021). Guidance on regulations for the transport of infectious substances 2021-2022. Retrieved from https://iris.who.int/bitstream/handle/10665/339825/9789240019720-eng.pdf?sequence=1