Analysis of heart rate variability in people living with HIV undergoing antiretroviral therapy (TARV) after practicing physical activity
Keywords:Physical exercise; Heart rate; AIDS serodiagnosis; Highly active antiretroviral therapy.
Acquired Immunodeficiency Syndrome (AIDS) is a disease caused by the Human Immunodeficiency Virus (HIV) that attacks the individual's defense cells, the TCD4 + lymphocytes causing a serious immune system disorder. Its treatment is based on therapy combined with antiretroviral medications that manage to control viral load and decrease the mortality rates of the disease. As an alternative, intervention strategies through the practice of physical exercises in order to assist in the treatment and quality of life of people living with HIV have been used for health benefits. This study aims to compare the heart rate variability (HRV) measured by a cardiofrequency meter, in HIV positive patients undergoing antiretroviral therapy (ART) at rest and after performing concurrent training (CT). The present study consists of an analytical, observational and cross-sectional research. The sample will consist of 15 people living with HIV and who are undergoing outpatient clinical follow-up at the Specialized Care Service (SAE) (Casa Rosa) in Barretos, in the interior of the state of São Paulo. To present the data, the Wilcoxon test was used to find which ones were different, the level of significance adopted was p <0.05. To verify the relationship of the results, Spearman's correlation coefficient test was used. The effect size was also calculated using the Cohen test (d). The analyzed data correlated the level of significance in all variables in the frequency and time domain, except for SDNN and SD2. There was a large effect size only for the parameter HF (Δ% = 279.92% reduction) in the frequency domain and in the parameters RMSSD (Δ% = 79.58% reduction) and SD1 (Δ% = 79.62% reduction) in the time domain in the TC, in the other parameters there was no great effect. Thus, one observes that the vagal resumption, which normally occurs after physical training, has not occurred or is returning slowly. While in the LF parameter there was a significant reduction, that is, a sympathetic withdrawal after the CT, even so, the sympathetic withdrawal was not total, since the parameter LF / HF (Δ% = 42.31% increase and TE = 0.70 ), that its increase means sympathetic activity, showed a significant increase after CT. In conclusion, the heart rate variability of the patients under study decreased after concurrent training, possibly due to the autonomic dysfunction shown in the literature for people living with HIV.
Artal, F.J.C.(2017). Infectious diseases causing autonomic dysfunction; Clinal Autonomic Research, 28(1), 67–81.
Borges, J.P.; Farinatti, P.T.V. (2011). Regulação autonômica da frequência cardíaca em pacientes infectados pelo HIV. Revista Brasileira de Fisiologia do Exercício - Volume 10 Número 4.
Brasil. (2018) Ministério da Saúde. Boletim Epidemiológico HIV AIDS. Brasília: Ministério da Saúde
Brasil. (2018) Secretaria de Vigilância em Saúde. Boletim Epidemiológico. Ministério da Saúde. Número Especial.
Brasil. (2018). Secretaria de Vigilância em Saúde. Departamento de Vigilância, Prevenção e Controle das Infecções Sexualmente Transmissíveis, do HIV/Aids e das Hepatites Virais. Protocolo Clínico e Diretrizes Terapêuticas para Manejo da Infecção pelo HIV em Adultos / Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Vigilância, Prevenção e Controle das Infecções Sexualmente Transmissíveis, do HIV/Aids e das Hepatites Virais. – Brasília : Ministério da Saúde.
Costa, L,A., & Almeida, A. G. (2015). Patologia cardiovascular associada ao vírus da imunodeficiência humana. Revista Portuguesa de Cardiologia, 34(7-8), 479–491.
Chaves, A.C.P, et al. (2014) Conhecimentos e atitudes de adolescentes de uma escola pública sobre a transmissão sexual do HIV; Revista Brasileira de Enfermagem. 67(1): 48-53.
Chetty, L., Cobbing, S., & Chetty, V. (2020). Physical activity and exercise for older people living with HIV: a protocol for a scoping review. Systematic Reviews, 9(1).
Chow, D.C., et al. (2011) Cardiovagal autonomic function in HIV-infected patients with unsupressed HIV viremia. HIV Clinical Trials. 12(3):141-150
Chow, D., et al. (2012) Effects of antiretro-viral therapy on autonomic function in early HIV infection:A preliminary report. Internacional Journal of Medical Sciences; 9(5), 397-405.
Chow, D.C., et al. (2015) Symptoms of autonomic dysfunction inhuman immunodeficiency virus. Open Forum Infectious Diseases. 2(3), ofv103.
Deeks, S. G., Lewin, S. R., & Havlir, D. V. (2013). The end of AIDS: HIV infection as a chronic disease. The Lancet, 382(9903), 1525–1533.
Dong, J-G. (2016) The role of heart rate variability in sports physiology. Experimental and therapeutic medicine. v. 11, n. 5, p. 1531-1536,
Esiri, M. M., Morris, C. S., & Millard, P. R. (1993). Sensory and sympathetic ganglia in HIV-1 infection: Immunocytochemical demonstration of HIV-1 viral antigens, increased MHC class II antigen expression and mild reactive inflammation. Journal of the Neurological Sciences, 114(2), 178–187.
Fang, X., et al. (2015). Resilience, stress, and life quality in older adults living with HIV/AIDS. Aging & Mental Health, 19(11), 1015–1021.
Faria, G.; Gude, A.S. & Lima, A.C.C. (2018) Perfil epidemiológico das notificações de AIDS e infecção pelo HIV na população de Cacoal no período de 2010 a 2016. Revista da Faculdade de Educação e Meio Ambiente -FAEMA, Ariquemes. v.9, n. 2, p.698-705.
Fronteira, I. (2013) Estudos observacionais na era da medicina baseada na evidência, Acta Medica Portuguesa. 26(2):161-170
Gill, J, et al. (2010) Causes of Death in HIV-1 – Infected Patients Treated with Antiretroviral Therapy, 1996-2006: Collaborative Analysis of 13 HIV Cohort Studies. Clinical Infectious Diseases. 50(10), 1387–1396.
Godijk, N.G., et al. Heart Rate Variability, HIV and the Risk of Cardiovascular Diseases in Rural South Africa. Global Heart. 2020; 15(1): 17.
Lebech, A-M., et al. (2007) Autonomic dysfunction in HIV patients on antiretroviral therapy: studies of heart rate variability. Clinical physiology and functional imaging, v. 27, n. 6, p. 363-367.
Lima, E.M., et al. Cardiovascular prevention in HIV patients: results from a successful interventionprogram. Atherosclerosis. 204(1), 229-232.
Mccraty, R. & Shaffer, F. (2015) Heart rate variability: new perspectives on physiological mechanisms, assessment of self-regulatory capacity, and health risk. Global advances in health and medicine, v. 4, n. 1, p. 46-61.
Mcintosh, R. C. (2016) A meta-analysis of HIV and heart rate variability in the era of antiretroviral therapy. Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society, v. 26, n. 4, p. 287–294.
Mittal, C.M., et al. (2004) Heart rate variability in human immunodeficiency virus-positive individuals. Internacional Journal of Cardiology. 94(1) :1–6.
Ozemek, C., Erlandson, K. M., & Jankowski, C. M. (2020). Physical activity and exercise to improve cardiovascular health for adults living with HIV. Progress in Cardiovascular Diseases. 63, 178–183
Pereira, G.F.M., et al. (2019) HIV/aids, hepatites virais e outras IST no Brasil: tendências epidemiológicas. Revista brasileira de epidemiologia. 22(suppl 1): e190001.supl.1
Pinto, T., et al. (2013) Benefícios do exercício físico para pacientes com HIV/AIDS. Revista Hospital Universitário Pedro Ernesto, 12(4):18-26
Quiles, N., Garber, C., & Ciccolo, J. (2017). Resting Autonomic Function in Active and Insufficiently Active People Living with HIV. International Journal of Sports Medicine, 39(01), 73–78.
Silva, J., et al. (2018) Estudo Comparativo De Docking Molecular Entre O Inibidor De Protease Saquinavir E O Carotenoide Bixina Como Potencial Inibidor Do Vírus Hiv Tipo I (1Hxb). Revista Expressão Católica Saúde, v. 3, n. 1, p. 35-41.
Tyor, W. R., et al. (1992) Cytokine expression in the brain during the acquired immunodeficiency syndrome. Annals of Neurology, 31(4), 349–360.
Umetani, K., et al. (1998) Twenty-four hour time domain heart rate variability and heart rate: relations to age and gender over nine decades. Journal of the American College of Cardiology, 31(3), 593–601.
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Copyright (c) 2021 Tayná Oliveira de Gois ; Cristiane Kelly Aquino dos Santos; Júlio César Camargo Alves; Estelio Henrique Martin Dantas
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