Efeitos do treinamento físico sobre o perfil lipídico, imunológico e composição corporal de pessoas vivendo com HIV: revisão sistemática e metanálise

Abstract

There is a growing number of publications involving physical training (PT) as a therapeutic adjuvant to HIV treatment and comorbidities associated with the use of antiretroviral therapy (ART). The objective of this systematic review with meta-analysis was to evaluate the effects of different ET methods on the immunological parameters, lipid profile and body composition of PLHIV. The systematic review with meta-analysis was carried out following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Searches were carried out in PubMed, Scielo, Medline, Europe PMC and Web of Science databases using the following combinations of descriptors from the Medical Subject Headings (MeSH) metadata system: exercise AND HIV, physical training AND HIV, aerobic exercise AND HIV, resistance exercise AND HIV, HIV AND CD4, HIV AND cholesterol, HIV AND lipid profile AND exercise, HIV AND body composition and HIV AND exercise NOT nutrition. To assess the quality of the evidence and the risk of bias in the study, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) protocol and the Risk of Bias 2 (RoB 2) tool were used, respectively. Of the fifteen RCTs that met established criteria, three used aerobic training, six resistance training, and six combined training in PLHIV. Meta-analysis revealed a significant overall effect for TF versus control for the reduction in body fat mass, body fat percentage, and plasma LDL levels. On the other hand, significant effects were not observed for CD4+ T cell count, HDL-c, total cholesterol, triglycerides, and lean body mass. TF contributed to the improvement of the lipid profile and body composition of PLHIV. TF seems to be a safe approach to attenuate the effects caused by the combination of viral infection and chronic use of ART.