IS PHYSICAL ADAPTATION TO EXERCISE RELATED TO TCD4 CELLS LEVEL IN HIV-INFECTED PEOPLE?

O.L.G. Atigossou¹, S.B.D. Fanou², A.S. Honado³, G. Reychler⁴, C.S. Batcho⁵

Background: Human Immunodeficiency Virus (HIV) infection is increasingly seen as a complex chronic disease that can impact the physical state of infected people, especially as they currently live longer with Highly Active Antiretroviral Therapy (HAART). For the initiation of this treatment, World Health Organization (WHO) has defined T lymphocytes Cluster-of-differentiation 4 (TCD4) limit rates to guide therapeutic decisions. These rates vary according to the pathological contexts and can be 200, 350 or 500 TCD4 cells/mm3. The higher the level of TCD4, the better the quality of life (QoL) of people living with HIV (PLWH). Knowing also that QoL is related to fitness condition, would there be a relationship between TCD4 cells level and fitness condition? Physical adaptation to exercise reflecting cardiorespiratory endurance is a major component of the fitness condition and easily measurable by physical tests such as the submaximal step test. Measuring this component in PLWH will assess a possible relationship between fitness condition and TCD4 cell level.

Purpose: To determine whether or not physical adaptation to exercise is related to TCD4 cells level among PLWH.  

Methods: Sixty-six participants [35 males, mean age±SD = 36.59±6.04 years old (range: 18 to 50 years old)] were recruited in Benin. Subjects were divided into two groups (male group and female group). Valid multistage step-test procedure was used to determine the index of physical adaptation to exercise (PW65%/kg) and index of the perception of effort to submaximal exercise (RPE65%). The number of performed stages during step-test was noted for each subject. Descriptive statistical analyses were reported as means and standard deviations (SD). Student t-test was used to compare the number of performed stages in the groups (male vs female). We used Pearson's correlation to determine the relationship according to sex between RPE65% and PW65%/kg, between TCD4 rates and PW65%/kg or RPE65%.    

Results: Median TCD4 rate (25th - 75th percentile) was 364.50 (179.00 - 504.50) cells/mm³, (range: 6 to 1268 cells/mm³). Mean±SD of PW65%/kg in male group was 5.09±1.50 and 4.32±1.19 in female group. The comparison of stages performed account in both groups during the step-test showed significant difference (t= 3.72; p < 0.0001).  Pearson's correlation have shown that RPE65% is related to PW65%/kg in male (r = 0.71; p < 0.0001) and in female (r = 0.61; p = 0.0001). TCD4 rates were not related to PW65%/kg neither in male (r = 0.17; p = 0.31) nor in female (r = 0.28; p = 0.12). Similarly, no significant relationship was observed between TCD4 rates and RPE65% neither in male (r = 0.20; p = 0.24) nor in female (r = 0.34; p = 0.055).

Conclusion(s): There seems to be no relationship between TCD4 cells level and physical adaptation to exercise among PLWH.

Implications: This study suggests that the levels of TCD4 cells have no influence on physical adaptation in PLWH and that exercise program can be designed to them under medical control, whatever the levels of TCD4 cells.

Funding, acknowledgements: This study was funded by own funds

Keywords: TCD4 cells, HIV, Physical adaptation to exercise

Topic: Cardiorespiratory

Did this work require ethics approval? Yes

Institution: Ouémé and Plateau Departmental University Hospital Center (CHUD-OP)

Committee: Local Committee of the Departmental University Hospital of Ouémé and Plateau

Ethics number: N°1610/2014CHD-OP/DIR/SAAE/SAF/SG/DGAP/SA