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Resistance training may increase CD4+ T-cell count in adults living with HIVResistance training may improve T-cell counts for people with HIV

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Key Takeaway
Note that while CD4+ T-cell counts may increase with resistance training, evidence quality is very low.

This meta-analysis evaluated the impact of resistance training or resistance-containing combined exercise compared to non-exercise controls in adults living with HIV. The analysis synthesized data from 13 trials to assess inflammatory biomarkers and CD4+ T-cell counts.

Regarding inflammatory markers, the meta-analysis found no significant effects for interleukin-6 (Hedges' g = -0.19), tumor necrosis factor alpha (Hedges' g = 0.07), C-reactive protein (Hedges' g = -0.02), interleukin-1 beta (Hedges' g = -0.47), or interleukin-10 (Hedges' g = 0.04). For interleukin-8, a pooled result was not available. For CD4+ T-cell count, the analysis reported a mean difference of 124.2 cells/mm3 favoring exercise, though the prediction interval crossed the no effect line.

The authors noted that the evidence is sparse, heterogeneous, and at risk of bias. Specifically, the certainty of the CD4+ T-cell count estimate is very low. Clinical application is limited by these uncertainties, and the effects of resistance-containing exercise on inflammatory biomarkers remain undetermined.

Living with HIV means managing a complex immune system every day. One of the most important markers of health in this journey is the CD4+ T-cell count, which helps determine how well the body can fight off infections. Researchers looked at 15 different trials to see if resistance training—exercises like lifting weights or using bands—could make a difference.

While the study did not find that resistance training changed common markers of inflammation in the body, it did show a potential increase in CD4+ T-cell counts. Specifically, the data showed a mean difference of 124.2 cells per cubic millimeter for those who exercised. However, it is important to take this finding with a grain of caution.

The researchers noted that the evidence is sparse and the data was quite varied across the different studies. Because of these inconsistencies, the certainty of the T-cell count estimate is very low. While the results are encouraging, the current data is not yet enough to make firm claims about how much exercise will change a person's specific health outcomes.

What this means for you:
Resistance training may increase T-cell counts in people with HIV, but current evidence is limited and uncertain.

Common questions

Does resistance training help with HIV?

The study found that resistance training may lead to an increase in CD4+ T-cell counts, which are important for immune health. However, the researchers noted that the evidence is sparse and the certainty of this specific finding is very low. You should talk to your doctor about how exercise fits into your specific treatment plan.

Does weight training reduce inflammation in people with HIV?

The study looked at several markers of inflammation, such as C-reactive protein and interleukin-6. In these specific tests, the researchers found no significant effect from resistance training. Because the data was varied and evidence is limited, these results are not definitive.

How many studies were included in this research?

The analysis included 15 different trials involving 18 reports. Out of those, 13 reports provided the specific numbers needed to calculate the results for T-cell counts and inflammatory markers.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
BackgroundAdults living with HIV may have persistent immune activation and low-grade inflammation despite effective antiretroviral therapy. We assessed whether resistance training or resistance-containing combined exercise alters inflammatory biomarkers or T-cell counts versus non-exercise control.MethodsSix databases were searched to 1 June 2026 without language restrictions. Controlled intervention studies lasting at least four weeks were eligible. Screening and extraction were performed independently in duplicate. Inflammatory outcomes were expressed as Hedges’ g; final-value SMDs were primary and change-score SMDs were analyzed separately, with one-trial strata reported individually. CD4+ T-cell count was pooled as a mean difference. Random-effects models used restricted maximum likelihood and Hartung-Knapp-Sidik-Jonkman intervals. RoB 2 or ROBINS-I and GRADE were applied.ResultsFifteen trials (18 reports) were included; 13 contributed quantitative data. All primary final-value confidence intervals included no effect: interleukin-6, −0.19 (95% CI −1.14 to 0.76; k = 4); tumor necrosis factor alpha, 0.07 (−1.44 to 1.57; k = 3); C-reactive protein, −0.02 (−1.46 to 1.41; k = 3); interleukin-1 beta, −0.47 (−10.09 to 9.15; k = 2); and interleukin-10, 0.04 (−11.37 to 11.46; k = 2). Interleukin-8 was reported by one final-value trial, −0.63 (−1.39 to 0.12), and was not pooled. Separate change-score analyses were also inconclusive except for one unpooled C-reactive protein trial. The pooled estimate for CD4+ T-cell count favored exercise by 124.2 cells/mm3 (54.6 to 193.7; k = 7), but the prediction interval crossed no effect. Certainty was very low.ConclusionThe effects of resistance-containing exercise on inflammatory biomarkers remain undetermined. The CD4+ estimate suggests a possible increase, but confidence is very limited because the evidence is sparse, heterogeneous, at risk of bias, and its prediction interval includes no effect. Larger trials with well-defined comparators and complete contrast-form reporting are needed.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261425700, identifier CRD420261425700.
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