EXERCISE AS A MEDIATOR OF PSYCHOLOGICAL AND NUTRITIONAL EFFECTS OF TESTOSTERONE THERAPY IN HIV+ MEN

Purpose: The purpose of this study was to determine whether exercise m ediates the psychological and nutritional effects of testosterone ther apy in men with symptomatic HIV illness, low serum testosterone, and c linical symptoms of hypogonadism. Methods: A 12-wk open trial of biwee kly intramuscular testosterone injections was conducted, with 54 men c ompleting the trial and exercise assessments. Most (71%) men were diag nosed with AIDS; 41% had a CD4 < 50. One-third of the men were diagnos ed with major depression, and nearly half had some evidence of wasting . Twenty-nine men (54%) engaged in exercise (predominantly resistance training) during the trial. Exercisers did not differ from nonexercise rs on any measure of psychological well being or nutritional status at baseline. Results: After 12 wk of testosterone treatment, those who e xercised showed significant improvement in mood (Hamilton Rating Scale for Depression; HAM-D) and overall distress (Brief Symptom Inventory; BSI) (P < 0.000 for both), as well as a significant increase in body cell mass (P < 0.01) and lean body mass (mean increase of 2.6 kg; P < 0.000) as measured by bioelectric impedance analysis. In contrast, non exercisers showed improvement on the HAM-D (P < 0.000), but not the BS I or measures of nutritional status. Conclusion: These findings indica te that exercise may be an important adjunct to testosterone therapy i n the treatment of psychological distress and wasting symptoms in men with symptomatic HIV illness.