Autonomic nervous system assessment in people with HIV: A cross-sectional study

Martin Rosario,Maryvi Gonzalez-Sola

doi:10.12688/f1000research.14685.1

Abstract

Background: People diagnosed with HIV may exhibit orthostatic hypotension (OH) as a result of the infection and of secondary effects of medications. Such impairments are attributed to autonomic nervous system (ANS) deficits. The purpose of this study was to assess OH during a balance sensory condition test (SCT) and evaluate the role of the cardiac autonomic system, regarding blood pressure (BP) and heart rate (HR), during this balancing task. We hypothesized that BP and heart rate would rise with an increase in postural instability, thus revealing OH. Methods: Eight individuals diagnosed with HIV were recruited from a community health center in the area of San Juan, Puerto Rico. BP and HR were measured after 5 minutes of sitting, immediately after standing up and 1 minute after this, during the SCT. A t-test was used to assess the difference between BP in sitting, BP in standing, and BP while performing the SCT. HR was also evaluated the same way. Results: There was an increase of more than 10 mmHg in systolic BP (SBP) from sitting compared to standing while performing the SCT (p≤0.01). Likewise, HR and SBP standing versus standing during the SCT increased significantly (p≤0.01). Conclusion: The results of this study show that the ANS may be impaired in people with HIV.

Highlights

HIV can destroy or substantially affect essential cells (CD4+T cells or T helper cells) of the immune system, which ordinarily help combat diseases
heart rate (HR) and systolic BP (SBP) standing versus standing during the sensory condition test (SCT) increased significantly (p≤0.01)
There is no cure for this disease, and if left untreated, it can progress to AIDS; medication to control HIV exists which can prolong the lives of patients (Song et al, 2017; WHO, 2011)

Summary

Introduction

HIV can destroy or substantially affect essential cells (CD4+T cells or T helper cells) of the immune system, which ordinarily help combat diseases. There is no cure for this disease, and if left untreated, it can progress to AIDS (acquired immune deficiency syndrome, defined as 200 or fewer CD4+ cells/μl); medication to control HIV exists (antiretroviral therapy) which can prolong the lives of patients (Song et al, 2017; WHO, 2011). The most common symptoms are fever, fatigue, weight loss, swollen lymph nodes and shingles, amongst others Neurological complications, such as difficulty walking, are often seen in patients with advanced stages of HIV or AIDS. People diagnosed with HIV may exhibit orthostatic hypotension (OH) as a result of the infection and of secondary effects of medications. Such impairments are attributed to autonomic nervous system (ANS) deficits. We hypothesized that BP and heart rate would rise with an increase in postural instability, revealing OH

Objectives

Methods

Results

Conclusion