Autonomic dysfunction as a predictor of heart disease in human immunodeficiency virus (HIV)

The purpose of this study was to test the presence of Autonomic Dysfunction (AD) in patients infected with Human Immunodeficiency Virus (HIV). 30 HIV (study) and non HIV (control) patients were prospectively enrolled and underwent five different established methods for detection of autonomic dysfunction. Amongst the five tests employed, there was a statistical difference in 4/5 tests between the two groups. The HIV patients studied had a statistically lower initial resting heart rate than the control group. The data shows that after 15 s, the resting heart rate was still significantly lower in the HIV group (p = 0.01) with no significant difference (p = 0.73) by 30 s. The ratio of the 30 to 15 s measurements suggests a substantial and highly significant (p < 0.0001) difference between the groups. In comparing the two groups with respect to a 2 min standing blood pressure difference, Diastolic blood pressure (DBP) was significantly different between the groups. In the exercise test, both group and the time factors were significant; the former at p < 0.0001 and the latter at p = 0.0001. There were significant differences of all blood pressure parameters during maximum exercise and recovery, with p < 0.0001 for all comparisons of the group factor. In the valsalva maneuver test, there was a statistical difference between the two groups during the longest r-r interval. Moreover, in the HIV group, there were more abnormal responses but these were not statistically significant. The relationship between HIV infection and cardiovascular disease is significant; this study aimed to show that HIV does affect the autonomic nervous system. The study demonstrates the high prevalence of autonomic dysfunction in HIV infected patients and the lack of correlation with markers of disease severity or disease duration. The patients studied showed an abnormal response to most tests employed (4/5).   Key words: Autonomic dysfunction, human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), nervous system, cardiovascular system.