Association between exercise and HIV disease progression in a cohort of homosexual men.
OBJECTIVE
To study the relationship between exercise and human immunodeficiency virus (HIV) disease progression.


METHODS
415 individuals (156 HIV positive, 259 HIV negative), from a cohort study of 851 homosexual men from New York City, 1985-1991. By 1991, 68 of the 156 persons developed Acquired Immune Deficiency Syndrome (AIDS) and 49 died with AIDS. Exercise was defined as self-report of exercising 3-4 times/week or daily at entry; less was considered nonexercise. CD4 lymphocyte decline was constructed for each subject by modeling log CD4 count against time in days. The association between exercise and progression to AIDS and death with AIDS, adjusting for baseline CD4 count, was determined using Cox model. Linear regression was used to model CD4 decline with exercise for HIV positive and HIV negative groups separately, adjusting for initial CD4 count.


RESULTS
Having exercised was associated with slower progression to AIDS at 1 year (HR = 0.68, 90% confidence interval (CI): 0.4-1.17); hazard ratios (HR) at 2, 3, and 4 years were 0.96, 1.18, and 1.36, respectively. Having exercised was also associated with slower progression to death with AIDS at 1 year (HR = 0.37, 90% CI: 0.14-0.94) with hazard ratios at 2, 3, and 4 years of 0.68, 0.98, and 1.27, respectively, suggesting a protective effect close to the time exercise was assessed, but an increased risk after 2 years. Exercising 3-4 times/week had a more protective effect than daily exercise. Exercisers in the HIV positive group showed an increase in CD4 count during a year by a factor of 1.07.


CONCLUSIONS
Moderate physical activity may slow HIV disease progression.
Division of Biostatistics, Department of Health and Environmental Control, Columbia, South Carolina, USA.
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Mustafa
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Macera
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Thompson
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Jackson
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Selassie
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Dean
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology; D000328:Adult; D000368:Aged; D001727:Bisexuality / Q000706:statistics & numerical data; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D015444:Exercise / Q000502:physiology; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology*; D015438:Health Behavior; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D013223:Statistics as Topic; D015996:Survival Rate; D013997:Time Factors