Effect of Aerobic Exercises and Resistance Exercises on Inflammatory Biomarkers and Fatigue in People Living with HIV Infection Undergoing Highly Active Antiretroviral Therapy; A Systematic Review Nwaka Ikechi I.1,*, Onwunzo Chinelo N.2, Ezeakunne Ugochukwu3, Ezeukwu Antoninus O.4, Ezugwu Uchechukwu A.5, Chigozie Uchenwoke I.5, Anieto Ebuka Miracle6 1MSc Candidate, Department of Medical Rehabilitation, Faculty of Heath sciences and technology, University of Nigeria, Enugu Campus, Enugu State, Nigeria 2Senior Physiotherapist, Physiotherapy unit, General hospital Ekwulobia, Ministry of Health, Awka, Anambra state, Nigeria 3Senior Physiotherapist, Physiotherapy Department, Chukwuemeka Odumegwu Ojukwu University teaching hospital, Amaku, Awka, Anambra state, Nigeria 4Senior Lecturer, Department of Medical Rehabilitation, University of Nigeria, Enugu Campus, Enugu State, Nigeria 5Lecturer, Department of Medical Rehabilitation, Faculty of Heath sciences and technology, University of Nigeria, Enugu Campus, Enugu State, Nigeria 6Physiotherapist Intern, Department of Physiotherapy, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria *Corresponding Author Ikechi I. Nwaka, MSc Candidate Department of Medical Rehabilitation, Faculty of Heath sciences and technology, University of Nigeria, Enugu Campus, Enugu State, Nigeria e-mail: ikechi.nwaka.pg80817@unn.edu.ng
Online published on 21 November, 2019. Abstract Background Elevation of inflammatory biomarkers markers among persons living with HIV (PLWH) is a serious side effect of highly active antiretroviral therapy in people living with HIV (PLWH), which has consequences in their overall health outcomes. Also, while HAART favours decreases in mortality and morbidity in PLWH, chronic HIV illness results in fatigue which also hampers patient health outcomes. This review therefore sought to evaluate the effect of exercise on inflammatory biomarkers (CRP, IL-6 and IL-β) and on fatigue in HIV patients receiving Highly actime anti-retrovirus therapy (HAART). Method Relevant medical databases were searched from years 1990 to 2018. Reference lists of identified studies were also searched. RCTs, quasi-RCTs and controlled clinical trials that investigated the effects of aerobic and/OR resistance exercises on inflammatory biomarkers and fatigue in PLWH (adults only) were included. Two reviewers assessed the methodological quality of identified studies independently; and extracted relevant data based on predefined criteria. Using available data, meta-analyses were performed for each outcome using random effects model. Results Eleven studies were included in this review (n=490 participants). Five studies included only male participants (n= 227), the rest had a combination of both males and females. Meta-analysis findings showed that aerobic and resistance exercise interventions have a significant effect in lowering IL-6 levels in the intervention group compared to the control group (Z=2.77, p=0.006). While these exercise interventions may also have lowering effects on CRP, IL-β and fatigue, meta-analysis showed a statistically non-significant effect (IL-β: Z=0.46, p=0.65, fatigue: Z=1.40, p=0.16). Conclusion Exercise interventions are beneficial in lowering inflammatory biomarkers and fatigue among PLWH undergoing HAART. Further research however should take note to include larger and more homogenous samples, minimize risk of bias and make use of valid, comprehensive tools for outcome assessment. Top Keywords Aerobic exercises, resistance exercises, HAART, biomarkers, fatigue. Top |