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Oct 31, 2000

Can exercise or physical fitness reduce the acceleration or progression of the HIV infection?

Response from Dr. Pavia

I would really like to tell you yes, and I recommend exercise to all my patients, but the truth is the science is a little unclear. I believe that exercise makes a difference, but here is the science.

There are a number of studies that show some immunologic benefits to aerobic exercise. Some studies have shown that people who are in good shape have fewer minor infections and miss fewer days of work. Aerobic exercise increases good cholesterol, lowers blood pressure, and can be quite effective at fighting or resisting depression. Resistance exercise maintains muscle mass, and very low muscle mass is associated with poor survival for HIV infected folks.

Sounds great so far. There are some buts though. There is no evidence that extra muscle mass improves survival over maintaining normal muscle mass (although there are some proponents of "getting big" by any means necessary, who I wouldn't want to fight about it with). There are no studies that I know of that have actually proven that those who exercise do better over the long run, but as you can imagine, those would be very hard studies to do. (Imagine: You have been randomized to sit on the couch for the next 5 years and watch "Survivor" reruns and your buddy is randomized to run 20 miles a week and go to the gym 3 times a week to hit the weights)

We may never prove this issue to a scientific certainty, but my advice to my patients is to stay reasonably fit and get some exercise at least 3 times a week, at a minimum.


Andrew T. Pavia, M.D.

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