title: Massage treatment in HIV-1 infected Dominican children: a preliminary report on the efficacy of massage therapy to preserve the immune system in children without antiretroviral medication.
abstract: OBJECTIVE
  More than 1.4 million children are living with HIV and global access to antiretrovirals is not yet readily available. Massage therapy, which has been shown to improve immune function in HIV+ adults and adolescents, may provide an important complementary treatment to boost immune status in young children living with HIV disease, especially those without access to antiretroviral medications. No studies have been conducted, however, that specifically target massage therapy to enhance immune function in HIV+ children.
  
  
  METHODS
  Clinical trial with eligible, consented HIV+ children randomized to receive either massage therapy or a friendly visit (controls).
  
  
  METHODS
  CENISMI/Robert Reid Cabral Hospital, Santo Domingo, Dominican Republic.
  
  
  METHODS
  HIV+ children ages 2-8 years.
  
  
  METHODS
  Massage therapy sessions (20 minutes, twice weekly, for 12 weeks), conducted by trained nurses, following a structured protocol of moderate pressure stroking and kneading of muscles, using a non-scented oil. The friendly visit control group, (reading, talking, playing quiet games), met with the nurse twice weekly for 12 weeks.
  
  
  METHODS
  At the initial evaluation, and following the 12-week intervention, blood was drawn to determine absolute helper (CD4/T4) and suppressor (CD8/T8) counts.
  
  
  RESULTS
  Children in the control arm had a greater relative risk of CD4 count decline (>20%) than massage-treated children (RR = 5.7, p = 0.03). Lymphocyte loss was also more extensive in the controls (p < 0.02), and more of the control group than the massage group lost >50 CD8 lymphocytes (p = 0.03).
  
  
  CONCLUSIONS
  The efficacy of massage therapy in maintaining immunocompetence may offer a viable alternative to the thousands of children worldwide without antiretroviral access.
authors.affiliation: Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami, FL.
authors.forename: Gail
authors.initials: G
authors.lastname: Shor-Posner
authors.forename: Maria-Jose
authors.initials: MJ
authors.lastname: Miguez
authors.forename: Maria
authors.initials: M
authors.lastname: Hernandez-Reif
authors.forename: Eddy
authors.initials: E
authors.lastname: Perez-Then
authors.forename: Maryann
authors.initials: M
authors.lastname: Fletcher
mesh_terms: D016516:CD4-CD8 Ratio; D018414:CD8-Positive T-Lymphocytes; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D004293:Dominican Republic; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008405:Massage / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome