Acquired Immune Deficiency Syndrome (AIDS)

Overview of AIDS

This condition is a suppression of the immune system from a progressive loss of cell-mediated and humoral immunity. The condition begins with the infection by the human immunodeficiency retrovirus (HIV) leading to the loss of T4-cell lymphocytes. A state of immunodeficiency results in clients being susceptible to infections, cancers, and other conditions. Clients will be on highly active antiretroviral therapies to suppress the effects of the HIV. Clients may have fatigue from secondary infections and other conditions that limit their daily activities, thus leading to deconditioning.^1,2 The implementation of a prescribed exercise program will reverse the effects of deconditioning without adversely affecting the clients' immune deficiency.³

Comorbidities to Consider

• Clients who develop painful peripheral neuropathies, arthritic conditions, and myopathies may need to limit activities to control symptoms.

Client Examination

Keys to Examination of Clients

• Ask the clients about their current level of lymphocytes; a CD4 lymphocyte count below 500/mm³ indicates immune deficiency.

• Discuss with the clients what type of testing and treatment are being received for secondary conditions.

Recommended Baseline Testing of Fitness Levels

• Cardiovascular fitness can be assessed with submaximal testing via treadmill, cycle ergometer, or walking tests.

• Muscle strength can be determined through free or machine weights using one-repetition or ten-repetition maximum testing.

• An assessment of the clients' level of anxiety or depression can be useful to determine the psychological effects of an exercise program.^3,4

Exercise Prescription

Type: Combination of aerobic and resistive exercise

Intensity: 60%–75% of maximum heart rate^3,5

Duration: Start at 20 minutes

Frequency: Three to five sessions per week.

Getting Started

Carefully choose the initial exercise parameters, and instruct your clients to avoid overexertion as they will need to avoid excessive fatigue to maintain a healthy immune system. Clients suffering bouts of depression, excessive anxiety, or poor sleep quality should maintain some level of exercise but may need to decrease the intensity of their exercise program.⁶ Clients should maintain their exercise program for at least 6 months to attain age-normal levels of endurance and cardiovascular fitness. Clients should benefit from the physical and psychologic effects of their exercise program.^3,4 When clients have progressed to a consistent exercise program, add resistive exercises for major muscle groups. Resistive exercises can be performed with intensities at 60% of maximum with 3 sets of 10 repetitions and a rest period of 1 to 2 minutes between sets.^3,7,8 Clients with AIDS may be able to progress their exercise programs to include moderate- and high-intensity aerobic and recreational activities.³