HIIT vs CME on Physical Function in Older Adults with HIV: HEALTH Trial Results

Overview

The HEALTH trial compared 16 weeks of high-intensity interval training (HIIT) versus continuous moderate-intensity exercise (CME) in sedentary older adults living with HIV. Both exercise modalities significantly improved physical function, measured by 400-meter walk time and muscle strength, with no statistically significant difference between the two groups.

Background

People with HIV (PWH) experience accelerated declines in physical function due to HIV-specific factors, chronic inflammation, and traditional risk factors. Exercise is a key intervention to improve physical function and maintain independence in this population. While continuous moderate-intensity exercise (CME) has demonstrated benefits, high-intensity interval training (HIIT) may offer additional cardiovascular and metabolic advantages. However, data comparing HIIT and CME in older PWH have been limited.

Data Highlights

Key Findings

• Both HIIT and CME significantly improved 400-meter walk time in older PWH after 16 weeks.
• Improvements in physical function and muscle strength were observed in both exercise groups.
• No statistically significant difference was found between HIIT and CME in primary or secondary outcomes.
• HIIT involved intervals at 90% heart rate reserve, while CME was continuous at 60% heart rate reserve.
• Participants were sedentary PWH aged ≥50 years, virologically suppressed on ART, with a median age of 57 years.

Clinical Implications

Both HIIT and CME are effective aerobic exercise strategies to improve physical function in older adults living with HIV. Clinicians should encourage PWH to engage in regular aerobic exercise tailored to individual preferences and tolerability, as either modality can yield meaningful functional benefits. Incorporating resistance training alongside aerobic exercise remains important for optimizing strength gains.

Conclusion

The HEALTH trial demonstrates that both high-intensity interval training and continuous moderate-intensity exercise improve physical function in older adults with HIV, with no significant superiority of HIIT over CME. Exercise prescriptions should be individualized to promote adherence and maximize benefits.

References

1. HEALTH Trial Investigators 2024 -- Evaluating the Impact of High-Intensity Interval Training Compared to Continuous Moderate-Intensity Exercise on Physical Function in Older Adults Living with HIV