Autonomic function and human immunodeficiency virus infection

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Abstract
We compared autonomic function in 26 patients infected by the human immunodeficiency virus (HIV) (18 AIDS and 8 ARC) to 22 controls. A signficant decline in autonomic function was present across groups. Autonomic dysfunction correlated strongly with signs of HIV-associated nervous system disease. We observed significiant differences across the groups in tests of heat rate variation (expiratory-inspiratory ratio, maximum minus minimum heart rate difference, and mean square successive difference), the mean arterial blood pressure fall to tilting, and the blood pressure response to isometric exercise. A trend of declining trend of declining autonomic function from controls to AIDS was present in the 30:15 ratio, the Valsalva ratio the systolic blood pressure fall to standing and tilt, and the cold pressor test. We did not observe any correlation between dysfunction and individual neurologic signs, prior therapeutic agents, and concurrent HIV-associated inflammatory or neoplastic processes. This study provides support for the presence of autonomic dysfunction in association with HIV infection. Autonomic dysfunction occurs more frequently and with greater severity in patients with AIDS; however, it may be present in the early stages if HIV infection and appears to progress during illness.

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