Massage HIV/AIDS 1

The Cellular Effects of Massage Therapy on Patients with HIV/AIDS

Tara Nicholls and Hailey Carruthers

Anatomy and Physiology 1

Professor Brian Dormer, RMT

Friday, November 14, 2008

 Massage HIV/AIDS 2

The Cellular Effects of Massage Therapy on Patients with HIV/AIDS

Introduction

HIV/AIDS is a devastating retrovirus that attacks the immune system which leaves the

victim vulnerable to opportunistic infection and various chronic illnesses such as cancer

(Health Canada, n.d.). The initial stage of infection known as Human Immunodeficiency

Virus (HIV) “is a retrovirus that infects cells of the human immune system, destroying or

impairing their function. In the early stages of infection, the person has no symptoms”

(WHO, n.d.). As the infection progresses in the body it can lead to the advanced stages of

HIV called Auto Immunodeficiency Syndrome (AIDS). It can take between 10-15 years

from the time a person contracts HIV to develop the advanced stages of AIDS (WHO,

n.d.). Although there are antiretroviral drugs that can help slow the process down, these

are not readily available in all countries with a high number of HIV/AIDS carriers and so

the use of alternative treatments has come to the forefront. Anything that can be done to

prolong the life or make HIV/AIDS patients more comfortable is crucial because

according to Health Canada (n.d.), AIDS is fatal and there is no cure. Perhaps then, if not

to cure, the use of alternative treatments such as massage therapy can slow down the

progress of the disease in a similar fashion to an antiretroviral medication and help to

boost the immunity of patients carrying the HIV/AIDS virus.

Discussion

One of the key ‘markers’ of HIV progression is the decline of CD4+ T cells. CD4+

cells are known as T-lymphocytes because they are developed in the Thymus gland. T-

cells are the immune systems helper cells (Vanderbilt, 2005). The HIV attaches itself to
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the CD4+ cells, and when the cells replicate, copies of the HIV virus are replicated as

well. This sets up a chain reaction that disables other parts of the body’s immune system.

Other cells that are affected in the same manner as the CD4+ T cells are “CD8 + T cells

(cytotoxic or suppressor cells)” (Vanderbilt, 2005). A “ratio of about one to two CD4 cells

to every CD8 cell” (Vanderbilt, 2005) is fairly normal in a healthy individual, but with an

HIV infection not only is there a decrease in cell production but there is also a notable

decrease in “the CD4-to-CD8 ratio, indicating a serious depletion of T-helper cells”

(Vanderbilt, 2005). When the CD4 cells are compromised it also affects the

communication to B cells, which are responsible for anti-bodies. Due to the expense of

the antiretroviral treatments, several studies have been done using alternative treatments,

such as Massage Therapy, on HIV/AIDS patients for its cost effectiveness and to

determine the effect CD4/CD8 ratio, and the effect massage therapy has on Natural Killer

(NK) cells.

Depression has been associated with immunosupression “through the effects that

epinephrine and norepinephrine have on immune function including decreased CD4

numbers and CD4-CD8 ratio” (Vanderbilt, 2005). Massage Therapy has been shown to

decrease stress hormones and anxiety and to induce relaxation “which may be the

mediator of the beneficial effects to the immune system” (Vanderbilt, 2005). This has

been well documented especially in research done over the last decade by the Touch

Research Institute of Miami, Florida (Vanderbilt, 2005). The “HIV infection is commonly

accompanied by psychological distress, often manifested as depression and anxiety,

which may increase HIV symptomology” (Diego et al, 2000). “An

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overproduction of cortisol and neuropeptides, caused by stress and anxiety may further

suppress the immune system” (Diego et al, 2000).

Through the use of Massage Therapy “relaxation and the maintenance of positive

mood have been associated with enhancements of immunological function” (Birk et al,

2000). “Ironson et al. (1996) studied the effects of daily massage therapy for 1 month in

HIV-infected subjects. Significant increases in natural killer (NK) cell levels were

demonstrated, but no similar increases in CD4+ lymphocytes were seen” (Birk et al,

2000). An increase “in natural killer cells have been shown to provide protection against

common AIDS opportunistic diseases such as tumours and viruses” (Diego et al, 2000).

Because this particular study only lasted for one month, ‘the massage therapy on HIV

men did not result in altered disease markers” (Diego et al, 2000) of the CD4+, CD8 and

the CD4/CD8 ratio (Diego et al, 2000). In a 12-week study in which 24 females with

HIV were given various alternative therapies, only the group given 20 minute massage

therapy sessions showed improvement in the CD4/CD8 ratio, and a reported decrease in

depression (Diego et al, 2000).

When daily massages were given to a group of “HIV+ adults, most of whom had not

taken antiretrovirals” (Shor-Posner et al, 2006) “massages were demonstrated to increase

NK cell cytotoxic capacity” (Shor-Posner et al, 2006). Adolescents undergoing two

massage treatments per week for 12 weeks were “reported to exhibit enhanced immune

function with increased NK cell numbers and improvement in markers of disease

progression (CD4 cell count and CD4/CD8 ratio)” (Shor-Posner et al, 2006). One study

consisting of 24 children in the Domincan Republic showed “compelling findings” (Shor-

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Posner et al, 2006). The 12 week study showed that “86% of the children in the massage

group showed an increase in CD4 cell count from baseline or remained stable (<30%

CD4 change) compared to 60% of the control group” (Shor-Posner et al, 2006). After the

12 week study, the test also showed a decrease in CD8 counts in the control group “but

not in the massage treated group” (Shor-Posner et al, 2006). Although there were higher

CD4 counts in the younger children, “at the final visit, it was also noted that measures of

CD8 cell counts and NK cells were similar in the two groups” (Shor-Posner et al, 2006).

The results of this study “indicate for the first time that massage therapy appears to have

a positive impact on immune function in HIV+ children who are not receiving

antiretroviral medications” (Shor-Posner et al, 2006).

Conclusion

Although there is presently no cure for HIV/AIDS, the studies that have been

completed using massage therapy as an alternative to antiretroviral treatments have

shown increased numbers in Natural Killer cells, CD4+, CD8 and CD4/CD8 ratios. Not

only has improvement been seen in helper cell production, the use of massage therapy

has also been shown to decrease depression in HIV/AIDS patients, in turn, boosting

much needed immunological functioning. It is clear that more studies need to be

completed on a larger scale to study the effects of massage therapy on a cellular level for

those inflicted with HIV/AIDS, but in the interim, it would appear that massage therapy

can only benefit and provide comfort to those without access to antiretroviral medication.
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References

Birk, TJ., McGrady, Al, MacArthur, RD., & Khuder, S. (2000, October). The effects of

massage therapy alone and in combination with other complementary therapies on

immune system measures and quality of life in human immunodeficiency virus.

Journal of Alternative and Complementary Medicine, 6(5), 405-414. Retrieved

October 10, 2008 from EbscoHost online database (MEDLINE Full Text Database).

Diego, MA., Field, T., Hernandez-Reif, M., Shaw, K., Friedman, L., & Ironson, G.

(2001, January). HIV adolescents show improved immune function following

massage therapy. The International Journal of Neuroscience, 106(1-2), 35-45.

Retrieved November 11, 2008 from EbscoHost online database (MEDLINE Full Text

Database).

Health Canada. (n.d.). HIV and AIDS. Retrieved November 2, 2008, from http://www.hc-

sc.gc.ca/dc-ma/aids-sida-index-eng.php

Shor-Posner, G., Hernandez-Reif, M., Miguez, MJ., Fletcher, M., Quintero, N., Baez, J.,

et al. (2006, July/August). The Impact of a Massage Therapy Clinical Trial on

Immune Status in Young Dominican Children Infected with HIV-1. Journal of

Alternative and Complementary Medicine, 12(6), 511-516. Retrieved October 27,

2008 from EbscoHost online database (Academic Search Premier).

Vanderbilt, S. (2005, August/September). Boosting Immunity Against HIV. Massage and

Bodywork, 20(4), 132-136. Retrieved September 25, 2008 from EbscoHost online

database (Alt Health Watch).

World Health Organization. (n.d.). HIV/AIDS. Retrieved November 11, 2008, from

http://www.who.int;topics/hiv_aids/en/