Abstract

Clinical Study of Cardiac Autonomic Dysfunction and QT Dispersion in Newly Diagnosed HIV Positive Individuals and its Correlation with CD4 Count

Background: HIV is a global pandemic with an estimated 38 million People Living with HIV (PLHIV) worldwide. Autonomic nervous dysfunction is seen more frequently in PLHIV and Cardiac autonomic dysfunction affects severely the quality of life in them. Early detection of autonomic neuropathy helps in the rehabilitation of PLHIV. Objectives: To evaluate the presence and extent of cardiac autonomic dysfunction and QT dispersion in newly diagnosed PLHIV, and To correlate autonomic with CD4 count. Method: Age and sex-matched Case-control study was conducted in the hospitals attached to Bangalore Medical College and Research Institute (BMCRI). 30 patients (15 HIV positive with AIDS and 15 HIV positive without AIDS) and 30 healthy controls who gave consent for the study and satisfied the inclusion and exclusion criteria were enrolled in the study. Cardiac autonomic function was assessed by Ewing’s battery of autonomic function tests and QT dispersion was measured. Statistical analysis was performed using SPSS software for Windows and a p-value <0.05 was considered significant. Results: Abnormal cardiac autonomic function was observed in 20% of patients with AIDS and 6.6% of patients without AIDS. There was statistically significant differences observed between PLHIV and controls for systolic blood pressure fall on standing (p=0.02), heart rate response to deep breathing (p=0.017), to standing(p=0.004), and to Valsalva maneuver(p=0.035). 33.3% of PLHIV had abnormal QT dispersion. Conclusions: Increase in the severity of cardiac dysautonomia was seen as the CD4 counts reduced to <200 cells/microL.QT dispersion is an important predictor of cardiac autonomic dysfunction. Autonomic function tests should be performed for early detection of cardiac dysautonomia which is an important contributor to mortality and morbidity in PLHIV.

• Full-Text
• PDF