Cardiac Autonomic Dysfunction in Human Immunodeficiency Virus Infected Patients: A Cross Sectional Study

Abstract

Background: Neurological complications involving central and peripheral nervous system are well described but there is paucity of literature on involvement of autonomic nervous system. HIV patients on ART have a higher prevalence of symptoms due to dysautonomia in comparison to normal individuals.Aims and objectives: To study the prevalence of cardiac autonomic dysfunction in PLHA (People living with HIV/ AIDS) with and without antiretroviral treatment.Methodology: It is a cross sectional study. The subjects are broadly divided into 3 categories with 25 patients in each group. PLHA on ART, PLHA not on ART and healthy controls.Observation and results: Three patients from ART group two from ART naive group had symptoms of syncope. There was a significant difference between the autonomic parameters in the control population as compared to that of PLHA, but no difference between those on ART and not on ART. The resting heart rate was significantly higher in PLHA compared to controls. On testing for sympathetic response, there was no notable difference between the median values of fall in systolic blood pressure between PLHA patients and control population. Respiratory sinus arrhythmia, expiration to inspiration ratio, in the controls was higher when compared to PLHA There is a significant difference in fall in systolic blood pressure between the HIV on ART and not on ART, however there was no significant difference in other autonomic parameters.Conclusion: This study shows that deterioration of parasympathetic function is more common than sympathetic function decline in HIV infected subjects as compared to normal population.