Background: Cardiorespiratory fitness (CRF) is a modifiable risk factor for cardiovascular disease and premature mortality. CRF levels and predictors among people living with HIV (PLWH) are unknown.
Purpose: (1) Investigate mean CRF in PLWH, (2) explore predictors of CRF, (3) compare CRF levels in PLWH versus age- and gender-matched healthy controls (HCs), and (4) explore predictors of CRF outcomes following physical activity (PA) interventions. .
Methods: Major electronic databases were searched systematically for articles reporting CRF expressed as maximum or peak oxygen uptake (ml/min/kg) in PLWH with or without HCs. A random effects meta-analysis calculating the pooled mean CRF including subgroup- and meta-regression analyses was undertaken.
Results: Across 21 eligible studies, the CRF level was 26.4 ml/kg/min (95%CI=24.6 to 28.1, p<0.001) (n=1,010; mean age at study level=41years). A higher body mass index (β=-0.99, 95%CI=-1.93 to -0.06, P=0.04), older age (β=-0.31, 95%CI=-0.58 to -0.04, P=0.02) and the presence of lipodystrophy (β=-4.63, 95%CI=-7.88 to -1.39, P=0.005) were significant predictors of lower CRF levels. Higher CRF levels were found in maximal versus submaximal tests (P<0.001) and in treadmill versus cycle ergometer tests (P=0.028). Higher CD4+ counts predicted a better CRF-outcome (β=0.004, 95%CI=0.0007 to 0.007, P=0.016). Better CRF-outcomes were also obtained following PA interventions that were supervised (P<0.001) and at a lower frequency (2 or 3 instead of 4) (P<0.001).
Conclusion: The CRF levels among PLWH are among the lowest levels reported in the literature. The clinical rehabilitation of PLWH should include a focus on assessing CRF in order to reduce all-cause mortality.