@phdthesis{PerezChaparro2022,
  author    = {P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto},
  title     = {Non-HIV comorbidities and exercise in German people living with HIV},
  doi       = {10.25932/publishup-56084},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-560842},
  school      = {Universit{\"a}t Potsdam},
  pages     = {149},
  year      = {2022},
  abstract  = {The post-antiretroviral therapy era has transformed HIV into a chronic disease and non-HIV comorbidities (i.e., cardiovascular and mental diseases) are more prevalent in PLWH. The source of these non-HIV comorbidities aside from traditional risk factor include HIV infection, inflammation, distorted immune activation, burden of chronic diseases, and unhealthy lifestyle like sedentarism. Exercise is known for its beneficial effects in mental and physical health; reasons why exercise is recommended to prevent and treat difference cardiovascular and mental diseases in the general population. This cumulative thesis aimed to comprehend the relation exercise has to non-HIV comorbidities in German PLWH. Four studies were conducted to 1) understand exercise effects in cardiorespiratory fitness and muscle strength on PLWH through a systematic review and meta-analyses and 2) determine the likelihood of German PLWH developing non-HIV comorbidities, in a cross-sectional study. Meta-analytic examination indicates PLWH cardiorespiratory fitness (VO2max SMD = 0.61 ml·kg·min-1, 95\% CI: 0.35-0.88, z = 4.47, p < 0.001, I2 = 50\%) and strength (of remark lowerbody strength by 16.8 kg, 95\% CI: 13-20.6, p< 0.001) improves after an exercise intervention in comparison to a control group. Cross-sectional data suggest exercise has a positive effect on German PLWH mental health (less anxiety and depressive symptoms) and protects against the development of anxiety (PR: 0.57, 95\%IC: 0.36 - 0.91, p = 0.01) and depression (PR: 0.62, 95\%IC: 0.41 - 0.94, p = 0.01). Likewise, exercise duration is related to a lower likelihood of reporting heart arrhythmias (PR: 0.20, 95\%IC: 0.10 - 0.60, p < 0.01) and exercise frequency to a lower likelihood of reporting diabetes mellitus (PR: 0.40, 95\%IC: 0.10 - 1, p < 0.01) in German PLWH. A preliminary recommendation for German PLWH who want to engage in exercise can be to exercise ≥ 1 time per week, at an intensity of 5 METs per session or > 103 MET·min·day-1, with a duration ≥ 150 minutes per week. Nevertheless, further research is needed to comprehend exercise dose response and protective effect for cardiovascular diseases, anxiety, and depression in German PLWH.},
  language  = {en}
}
@article{PerezChaparroKangasZechetal.2022,
  author    = {P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Kangas, Maria and Zech, Philipp and Schuch, Felipe B. and Rapp, Michael A. and Heißel, Andreas},
  title     = {Recreational exercise is associated with lower prevalence of depression and anxiety and better quality of life in German people living with HIV},
  series = {AIDS care : psychological and socio-medical aspects of AIDS/HIV},
  volume    = {34},
  journal   = {AIDS care : psychological and socio-medical aspects of AIDS/HIV},
  number    = {2},
  publisher = {Taylor \& Francis Group},
  address   = {London [u.a.]},
  issn      = {1360-0451},
  doi       = {10.1080/09540121.2021.1889951},
  pages     = {182 -- 187},
  year      = {2022},
  abstract  = {Sedentarism is a risk factor for depression and anxiety. People living with the human immunodeficiency virus (PLWH) have a higher prevalence of anxiety and depression compared to HIV-negative individuals. This cross-sectional study (n = 450, median age 44 (19-75), 7.3\% females) evaluates the prevalence rates and prevalence ratio (PR) of anxiety and/or depression in PLWH associated with recreational exercise. A decreased likelihood of having anxiety (PR=0.57; 0.36-0.91; p = 0.01), depression (PR=0.41; 0.36-0.94; p=0.01), and comorbid anxiety and depression (PR = 0,43; 0.24-0.75; p=0.002) was found in exercising compared to non-exercising PLWH. Recreational exercise is associated with a lower risk for anxiety and/or depression. Further prospective studies are needed to provide insights on the direction of this association.},
  language  = {en}
}
@misc{PerezChaparroSchuchZechetal.2021,
  author    = {P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Schuch, Felipe Barreto and Zech, Philipp and Kangas, Maria and Rapp, Michael Armin and Heißel, Andreas},
  title     = {Recreational Exercising and Self-Reported Cardiometabolic Diseases in German People Living with HIV: A Cross-Sectional Study},
  series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  volume    = {18},
  journal   = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  edition   = {21},
  publisher = {Universit{\"a}tsverlag Potsdam},
  address   = {Potsdam},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-55204},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-552049},
  pages     = {1 -- 10},
  year      = {2021},
  abstract  = {Exercise is known for its beneficial effects on preventing cardiometabolic diseases (CMDs) in the general population. People living with the human immunodeficiency virus (PLWH) are prone to sedentarism, thus raising their already elevated risk of developing CMDs in comparison to individuals without HIV. The aim of this cross-sectional study was to determine if exercise is associated with reduced risk of self-reported CMDs in a German HIV-positive sample (n = 446). Participants completed a self-report survey to assess exercise levels, date of HIV diagnosis, CD4 cell count, antiretroviral therapy, and CMDs. Participants were classified into exercising or sedentary conditions. Generalized linear models with Poisson regression were conducted to assess the prevalence ratio (PR) of PLWH reporting a CMD. Exercising PLWH were less likely to report a heart arrhythmia for every increase in exercise duration (PR: 0.20: 95\% CI: 0.10-0.62, p < 0.01) and diabetes mellitus for every increase in exercise session per week (PR: 0.40: 95\% CI: 0.10-1, p < 0.01). Exercise frequency and duration are associated with a decreased risk of reporting arrhythmia and diabetes mellitus in PLWH. Further studies are needed to elucidate the mechanisms underlying exercise as a protective factor for CMDs in PLWH.},
  language  = {en}
}
@article{PerezChaparroSchuchZechetal.2021,
  author    = {P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Schuch, Felipe Barreto and Zech, Philipp and Kangas, Maria and Rapp, Michael Armin and Heißel, Andreas},
  title     = {Recreational exercising and self-reported cardiometabolic diseases in German people living with HIV},
  series = {International journal of environmental research and public health : IJERPH / Molecular Diversity Preservation International},
  volume    = {18},
  journal   = {International journal of environmental research and public health : IJERPH / Molecular Diversity Preservation International},
  number    = {21},
  publisher = {MDPI},
  address   = {Basel, Schweiz},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph182111579},
  pages     = {1 -- 10},
  year      = {2021},
  abstract  = {Exercise is known for its beneficial effects on preventing cardiometabolic diseases (CMDs) in the general population. People living with the human immunodeficiency virus (PLWH) are prone to sedentarism, thus raising their already elevated risk of developing CMDs in comparison to individuals without HIV. The aim of this cross-sectional study was to determine if exercise is associated with reduced risk of self-reported CMDs in a German HIV-positive sample (n = 446). Participants completed a self-report survey to assess exercise levels, date of HIV diagnosis, CD4 cell count, antiretroviral therapy, and CMDs. Participants were classified into exercising or sedentary conditions. Generalized linear models with Poisson regression were conducted to assess the prevalence ratio (PR) of PLWH reporting a CMD. Exercising PLWH were less likely to report a heart arrhythmia for every increase in exercise duration (PR: 0.20: 95\% CI: 0.10-0.62, p < 0.01) and diabetes mellitus for every increase in exercise session per week (PR: 0.40: 95\% CI: 0.10-1, p < 0.01). Exercise frequency and duration are associated with a decreased risk of reporting arrhythmia and diabetes mellitus in PLWH. Further studies are needed to elucidate the mechanisms underlying exercise as a protective factor for CMDs in PLWH.},
  language  = {en}
}
@article{ZechSchuchPerezChaparroetal.2020,
  author    = {Zech, Philipp and Schuch, Felipe and P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Kangas, Maria and Rapp, Michael Armin and Heissel, Andreas},
  title     = {Exercise, Comorbidities, and Health-Related Quality of Life in People Living with HIV},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {17},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {14},
  publisher = {MDPI AG},
  address   = {Basel},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph17145138},
  pages     = {15},
  year      = {2020},
  abstract  = {(1) Background: People with HIV (PWH) may perform more than one type of exercise cumulatively. The objective of this study is to investigate recreational exercise and its association with health-related quality of life (HRQOL) and comorbidities in relation to potential covariates. (2) Methods: The HIBES study (HIV-Begleiterkrankungen-Sport) is a cross-sectional study for people with HIV. The differences between non-exercisers versus exercisers (cumulated vs. single type of exercises) were investigated using regression models based on 454 participants. (3) Results: Exercisers showed a higher HRQOL score compared to non-exercisers (Wilcox r = 0.2 to 0.239). Psychological disorders were identified as the main covariate. Participants performing exercise cumulatively showed higher scores in duration, frequency, and intensity when compared to participants performing only one type of exercise. The mental health summary score was higher for the cumulated and single type of exercise if a psychological disorder existed. Duration and intensity were associated with an increase of HRQOL, whilst a stronger association between psychological disorders and exercise variables were evident. Exercise duration (minutes) showed a significant effect on QOL (standardized beta = 0.1) and for participants with psychological disorders (standardized beta = 0.3), respectively. (4) Conclusions: Psychological disorders and other covariates have a prominent effect on HRQOL and its association with exercise. For PWH with a psychological disorder, a stronger relationship between HRQOL with exercise duration and intensity emerged. However, differentiation of high-HRQOL individuals warrants further investigation by considering additional factors.},
  language  = {en}
}
@misc{ZechSchuchPerezChaparroetal.2020,
  author    = {Zech, Philipp and Schuch, Felipe and P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Kangas, Maria and Rapp, Michael Armin and Heissel, Andreas},
  title     = {Exercise, Comorbidities, and Health-Related Quality of Life in People Living with HIV},
  series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  number    = {661},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-48028},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-480289},
  pages     = {15},
  year      = {2020},
  abstract  = {(1) Background: People with HIV (PWH) may perform more than one type of exercise cumulatively. The objective of this study is to investigate recreational exercise and its association with health-related quality of life (HRQOL) and comorbidities in relation to potential covariates. (2) Methods: The HIBES study (HIV-Begleiterkrankungen-Sport) is a cross-sectional study for people with HIV. The differences between non-exercisers versus exercisers (cumulated vs. single type of exercises) were investigated using regression models based on 454 participants. (3) Results: Exercisers showed a higher HRQOL score compared to non-exercisers (Wilcox r = 0.2 to 0.239). Psychological disorders were identified as the main covariate. Participants performing exercise cumulatively showed higher scores in duration, frequency, and intensity when compared to participants performing only one type of exercise. The mental health summary score was higher for the cumulated and single type of exercise if a psychological disorder existed. Duration and intensity were associated with an increase of HRQOL, whilst a stronger association between psychological disorders and exercise variables were evident. Exercise duration (minutes) showed a significant effect on QOL (standardized beta = 0.1) and for participants with psychological disorders (standardized beta = 0.3), respectively. (4) Conclusions: Psychological disorders and other covariates have a prominent effect on HRQOL and its association with exercise. For PWH with a psychological disorder, a stronger relationship between HRQOL with exercise duration and intensity emerged. However, differentiation of high-HRQOL individuals warrants further investigation by considering additional factors.},
  language  = {en}
}
@misc{PerezChaparroMayerBeckendorf2019,
  author    = {P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Mayer, Frank and Beckendorf, Claudia},
  title     = {Cardiovascular drift response over two different constant-load exercises in healthy non-athletes},
  series = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  volume    = {51},
  journal   = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine},
  number    = {6},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0195-9131},
  doi       = {10.1249/01.mss.0000561495.15163.50},
  pages     = {329 -- 329},
  year      = {2019},
  abstract  = {Cardiovascular drift (CV-d) is a steady increase in heart rate (HR) over time while performing constant load moderate intensity exercise (CME) > 20 min. CV-d presents problems for the prescription of exercise intensity by means of HR, because the work rate (WR) during exercise must be adjusted to maintain target HR, thus disturbing the intended effect of the exercise intervention. It has been shown that the increase in HR during CME is due to changes in WR and not to CV-d.},
  language  = {en}
}
@misc{PerezChaparroZechSchuchetal.2018,
  author    = {P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Zech, Philipp and Schuch, Felipe and Wolfarth, Bernd and Rapp, Michael Armin and Heiβel, Andreas},
  title     = {Effects of aerobic and resistance exercise alone or combined on strength and hormone outcomes for people living with HIV},
  series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  number    = {476},
  issn      = {1866-8364},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-419556},
  pages     = {21},
  year      = {2018},
  abstract  = {Background: Infection with human immunodeficiency virus (HIV) affects muscle mass, altering independent activities of people living with HIV (PLWH). Resistance training alone (RT) or combined with aerobic exercise (AE) is linked to improved muscle mass and strength maintenance in PLWH. These exercise benefits have been the focus of different meta-analyses, although only a limited number of studies have been identified up to the year 2013/4. An up-to-date systematic review and meta-analysis concerning the effect of RT alone or combined with AE on strength parameters and hormones is of high value, since more and recent studies dealing with these types of exercise in PLWH have been published. Methods: Randomized controlled trials evaluating the effects of RT alone, AE alone or the combination of both (AERT) on PLWH was performed through five web-databases up to December 2017. Risk of bias and study quality was attained using the PEDro scale. Weighted mean difference (WMD) from baseline to post-intervention changes was calculated. The I2 statistics for heterogeneity was calculated. Results: Thirteen studies reported strength outcomes. Eight studies presented a low risk of bias. The overall change in upper body strength was 19.3 Kg (95\% CI: 9.8±28.8, p< 0.001) after AERT and 17.5 Kg (95\% CI: 16±19.1, p< 0.001) for RT. Lower body change was 29.4 Kg (95\% CI: 18.1±40.8, p< 0.001) after RT and 10.2 Kg (95\% CI: 6.7±13.8, p< 0.001) for AERT. Changes were higher after controlling for the risk of bias in upper and lower body strength and for supervised exercise in lower body strength. A significant change towards lower levels of IL-6 was found (-2.4 ng/dl (95\% CI: -2.6, -2.1, p< 0.001). Conclusion: Both resistance training alone and combined with aerobic exercise showed a positive change when studies with low risk of bias and professional supervision were analyzed, improving upper and, more critically, lower body muscle strength. Also, this study found that exercise had a lowering effect on IL-6 levels in PLWH.},
  language  = {en}
}
@article{PerezChaparroZechSchuchetal.2018,
  author    = {P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Zech, Philipp and Schuch, Felipe and Wolfarth, Bernd and Rapp, Michael Armin and Heiβel, Andreas},
  title     = {Effects of aerobic and resistance exercise alone or combined on strength and hormone outcomes for people living with HIV},
  series = {PLOS One},
  volume    = {13},
  journal   = {PLOS One},
  number    = {9},
  publisher = {PLOS},
  address   = {San Francisco},
  issn      = {1932-6203},
  doi       = {10.1371/journal.pone.0203384},
  pages     = {1 -- 12},
  year      = {2018},
  abstract  = {Background: Infection with human immunodeficiency virus (HIV) affects muscle mass, altering independent activities of people living with HIV (PLWH). Resistance training alone (RT) or combined with aerobic exercise (AE) is linked to improved muscle mass and strength maintenance in PLWH. These exercise benefits have been the focus of different meta-analyses, although only a limited number of studies have been identified up to the year 2013/4. An up-to-date systematic review and meta-analysis concerning the effect of RT alone or combined with AE on strength parameters and hormones is of high value, since more and recent studies dealing with these types of exercise in PLWH have been published. Methods: Randomized controlled trials evaluating the effects of RT alone, AE alone or the combination of both (AERT) on PLWH was performed through five web-databases up to December 2017. Risk of bias and study quality was attained using the PEDro scale. Weighted mean difference (WMD) from baseline to post-intervention changes was calculated. The I2 statistics for heterogeneity was calculated. Results: Thirteen studies reported strength outcomes. Eight studies presented a low risk of bias. The overall change in upper body strength was 19.3 Kg (95\% CI: 9.8±28.8, p< 0.001) after AERT and 17.5 Kg (95\% CI: 16±19.1, p< 0.001) for RT. Lower body change was 29.4 Kg (95\% CI: 18.1±40.8, p< 0.001) after RT and 10.2 Kg (95\% CI: 6.7±13.8, p< 0.001) for AERT. Changes were higher after controlling for the risk of bias in upper and lower body strength and for supervised exercise in lower body strength. A significant change towards lower levels of IL-6 was found (-2.4 ng/dl (95\% CI: -2.6, -2.1, p< 0.001). Conclusion: Both resistance training alone and combined with aerobic exercise showed a positive change when studies with low risk of bias and professional supervision were analyzed, improving upper and, more critically, lower body muscle strength. Also, this study found that exercise had a lowering effect on IL-6 levels in PLWH.},
  language  = {en}
}