The Impact of Moderate or High-Intensity Combined Exercise on Systemic Inflammation Among Older Persons With and Without HIV

Abstract

Background: We investigated whether higher-intensity exercise provided greater decrease in markers of inflammation, and whether responses differed by HIV serostatus.

Methods: People with HIV (PWH; n = 32) and controls (n = 37) aged 50-75 years completed 12 weeks moderate-intensity exercise, then were randomized to moderate- or high-intensity exercise for 12 additional weeks (n = 27 and 29, respectively). Inflammation biomarkers were measured at 0, 12, 24 weeks. Mixed and multiple regression models were adjusted for baseline inflammation, age, and body mass index.

Results: Baseline tumor necrosis factor-α (TNF-α), soluble TNF receptor 2 (sTNFR2), and soluble CD14 (sCD14) were significantly higher among PWH than controls (P < .04). From week 0-12, changes in interleukin-6 (IL-6), TNF-α, and sTNFR1 were not significantly different by HIV serostatus. We found no significant interaction between HIV serostatus/exercise intensity on week 12-24 changes in IL-6, TNF-α, and sTNFR1. Among high-intensity exercisers, PWH and controls had significant increases in sCD14 (P ≤ .003), controls significant increases in IL-10 (P = .01), and PWH nonsignificant decrease in highly sensitive C-reactive protein (P = .07). Other markers were not significantly different by serostatus or intensity.

Conclusions: Moderate and high-intensity exercise elicited similar effects on inflammation among PWH and controls, with additional beneficial effects seen among high-intensity exercisers. Increase in sCD14 and attenuated IL-10 increase (PWH only) merit further study.

Clinical trials registration: NCT02404792.

Keywords: exercise; inflammation; microbial translocation; monocyte function.

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Figures

Figure 1.

A, Monocyte subgroups by HIV serostatus at baseline and 12 weeks are shown with compositional monocyte data. B, Ratio of monocyte components among PWH compared to controls (reference). As shown, the intermediate monocytes increased and nonclassical decreased among PWH compared to uninfected controls. C, Median (interquartile range) percent change from week 0 to 12 in cytokines following low-dose LPS stimulation, among PWH (red circles) or controls (blue squares), using Wilcoxon signed rank tests. Abbreviations: CXCL-10, C-X-C motif chemokine ligand 10; HIV, human immunodeficiency virus; IL, interleukin; LPS, lipopolysaccharide; PWH, people with HIV; TNF-α, tumor necrosis factor-α.

Figure 2.

Mean (95% confidence interval) percent change in IL-6 (A), TNF-α (B), and sTNFR1 (C) from week 0 to week 12 by HIV serostatus, and week 12 to 24 by HIV serostatus and exercise intensity (by multivariable regression models, adjusted for age, body mass index, and baseline inflammatory marker). Abbreviations: HIV, human immunodeficiency virus; IL-6, interleukin-6; PWH, people with HIV; sTNFR1, soluble tumor necrosis factor receptor 1; TNF-α, tumor necrosis factor-α.

Figure 3.

Mean (95% confidence interval) percent change in IL-6 (A), TNF-α (B), and sTNFR1 (C) from week 0 to week 12 by HIV serostatus, and week 12 to 24 by HIV serostatus (moderate and high-intensity combined). Results from multivariable regression models, adjusted for age, body mass index, and baseline inflammatory marker. Abbreviations: HIV, human immunodeficiency virus; IL-6, interleukin-6; sTNFR1, soluble tumor necrosis factor receptor 1; TNF-α, tumor necrosis factor-α.

Figure 4.

Mean (95% confidence interval) percent change in IL-6, TNF-α, and sTNFR1 from week 12 to 24 by exercise intensity (HIV serostatus groups combined). Results from multivariable regression models, adjusted for age, body mass index, and baseline inflammatory marker. Abbreviations: HIV, human immunodeficiency virus; IL-6, interleukin-6; sTNFR1, soluble tumor necrosis factor receptor 1; TNF-α, tumor necrosis factor-α.

Figure 5.

Mean (95% confidence interval) percent change in exploratory cytokines from week 0 to 24 by HIV serostatus and exercise intensity (A), HIV serostatus with exercise intensity combined (B), and exercise intensity with HIV serostatus (C). Results from multivariable regression models, adjusted for age, body mass index, and baseline inflammatory marker. Abbreviations: HIV, human immunodeficiency virus; hsCRP, highly sensitive C-reactive protein; I-FABP, intestinal fatty acid binding protein; IL-10, interleukin-10; MOD, moderate; PWH, people with HIV; sCD14, soluble CD14; sTNFR1, soluble tumor necrosis factor receptor 1; TNF-α, tumor necrosis factor-α.