Correlation of Cardiac Autonomic Dysfunction with CD4 Count in Human Immunodeficiency Virus Patients
Journal Title: Journal of Krishna Institute of Medical Sciences University - Year 2019, Vol 8, Issue 2
Abstract
Background: Almost all organs and systems in the body are affected by Human Immunodeficiency Virus (HIV) infection. Autonomic nervous system involvement and cardiac autonomic dysfunction is known to affect severely the quality of life in HIV patients due to fatal consequences in later stages of the disease. Aim and Objectives: Assessment of cardiac autonomic dysfunction on HIV infection/Acquired Immunodeficiency Disease Syndrome (AIDS) patients and to correlate the degree of dysfunction with Cluster of Differentiation 4 (CD4) count. Material and Methods: Fifty one human HIV sero-positive patients with 20 HIV sero-positive patients without AIDS and 31 with AIDS and 51 controls were studied for cardiac autonomic dysfunction in a tertiary care medical college hospital. The assessment of cardiac autonomic function was done by series of autonomic function tests. The number of abnormal test results correlated with CD4 count. Results: In patients with HIV, abnormal cardiac autonomic functions were observed in 5.6% of patients without AIDS and 37.5% of patients with AIDS. Significant differences between HIV patients and controls was observed for systolic blood pressure response to standing (p<0.001), diastolic blood pressure response to persistent handgrip (p<0.001), heart rate variability to standing (p<0.001), Valsalva maneuver (p<0.001) and to deep breathing (p=0.001). Abnormalities in cardiac autonomic function occurred at all levels of CD4 counts. Our study showed an increase in incidence of cardiac autonomic dysfunction as the CD4 count decreased. Conclusion: The affection of various organs and systems is a consequence of autonomic dysfunction in HIV infection and often invasive procedures are required for diagnostic and therapeutic decisions. When HIV patients present with symptoms like dizziness and headache which can be present in many conditions, cardiac autonomic dysfunction should be first ruled out by performing simple autonomic dysfunction tests before resource consuming expensive and invasive tests were performed later only if needed.
Authors and Affiliations
Sharan Badiger
Keywords
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