Symptoms of Autonomic Dysfunction in Human Immunodeficiency Virus

Chow, Dominic C.; Nakamoto, Beau K.; Sullivan, Katherine; Sletten, David M.; Fujii, Satomi; Umekawa, Sari; Kocher, Morgan; Kallianpur, Kalpana J.; Shikuma, Cecilia; Low, Phillip A.

doi:10.1093/ofid/ofv103

Cited by 15 publications

(9 citation statements)

References 15 publications

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“…Notably, the lack of association between HIV and prevalent hypertension has been described in other African populations ( Okello et al, 2017 ;Kwarisiima et al, 2016 ), including a meta-analysis of 29,755 participants ( Dillon et al, 2013 ). These observations are variously attributed to autonomic cardiovascular dysfunction (autonomia) in chronic HIV infection ( Carod-Artal, 2018 ;Chow et al, 2015 ;Compostella et al, 2008 ;Robinson-Papp and Sharma, 2013 ;Rogstad et al, 1999 ). Autonomia is characterized by increased resting HR, reduced HR variability, and blunted BP responses to stress.…”

Section: Discussionmentioning

confidence: 97%

Association between HIV and Prevalent Hypertension and Diabetes Mellitus in South Africa: Analysis of a Nationally Representative Cross-Sectional Survey

Magodoro

Okello

Dungeni

et al. 2022

International Journal of Infectious Diseases

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Section: Discussionmentioning

confidence: 97%

Association between HIV and Prevalent Hypertension and Diabetes Mellitus in South Africa: Analysis of a Nationally Representative Cross-Sectional Survey

Magodoro

Okello

Dungeni

et al. 2022

International Journal of Infectious Diseases

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“…On the one hand, post-infectious dysautonomia has previously been described in relation to other pathogens, including Chagas disease, human immunodeficiency virus (HIV), Epstein-Barr virus, and rabies virus 11 , 12 . Autonomic dysfunction is relatively common among HIV-infected patients, as inferred from a decrease in the HRV in the early stages of infection in many of these patients 13 .…”

Section: Discussionmentioning

confidence: 99%

Inappropriate sinus tachycardia in post-COVID-19 syndrome

Aranyo

Bazán

Lladós

et al. 2022

Sci Rep

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Inappropriate sinus tachycardia (IST) is a common observation in patients with post-COVID-19 syndrome (PCS) but has not yet been fully described to date. To investigate the prevalence and the mechanisms underlying IST in a prospective population of PCS patients. Consecutive patients admitted to the PCS Unit between June and December 2020 with a resting sinus rhythm rate ≥ 100 bpm were prospectively enrolled in this study and further examined by an orthostatic test, 2D echocardiography, 24-h ECG monitoring (heart rate variability was a surrogate for cardiac autonomic activity), quality-of-life and exercise capacity testing, and blood sampling. To assess cardiac autonomic function, a 2:1:1 comparative sub-analysis was conducted against both fully recovered patients with previous SARS-CoV-2 infection and individuals without prior SARS-CoV-2 infection. Among 200 PCS patients, 40 (20%) fulfilled the diagnostic criteria for IST (average age of 40.1 ± 10 years, 85% women, 83% mild COVID-19). No underlying structural heart disease, pro-inflammatory state, myocyte injury, or hypoxia were identified. IST was accompanied by a decrease in most heart rate variability parameters, especially those related to cardiovagal tone: pNN50 (cases 3.2 ± 3 vs. recovered 10.5 ± 8 vs. non-infected 17.3 ± 10; p < 0.001) and HF band (246 ± 179 vs. 463 ± 295 vs. 1048 ± 570, respectively; p < 0.001). IST is prevalent condition among PCS patients. Cardiac autonomic nervous system imbalance with decreased parasympathetic activity may explain this phenomenon.

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“…The vagus nerve and the thoracic spinal sympathetic outflow may be involved in patients with Parkinson’s disease, multiple sclerosis, brainstem stroke, brainstem tumors, diabetic neuropathy, amyloid neuropathy or primary dysautonomia [ 27 , 29 ]. Furthermore, involvement of the myenteric neuronal plexus may be seen in patients with diffuse neurological disorders such as diabetes, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), and Parkinson’s disease [ 29 , 30 ]. Of all the neurological disorders, Parkinson’s disease is closely associated with GP and may be seen in about 7.5% of all patients with GP [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Diabetic and Non-Diabetic Gastroparesis: A Retrospective Comparative Outcome Study From the Nationwide Inpatient Sample

et al. 2021

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Background Gastroparesis (GP), meaning “gastric palsy”, is a chronic medical condition characterized by delayed or absent gastric emptying in the absence of mechanical obstruction. The primary objective of this study was to determine the patient-specific outcomes and the burden of GP on the US healthcare system. Methods This was a population-based, retrospective study designed to analyze data available from the Nationwide Inpatient Sample (NIS) for 2016 and 2017. Using the International Classification of Diseases, Tenth Revision (ICD-10) codes, we identified adult (18 years or older) hospitalizations with a principal diagnosis of GP. The study sample was further classified into two distinct groups based on the presence or absence of GP, namely diabetic GP (DGP) and non-diabetic GP (NDGP). The primary outcome of our study was inpatient mortality secondary to GP while the secondary outcomes included the odds of system-based complications and the burden of the disease on the United States healthcare system. Results We identified 99,695 adult (≥ 18 years) hospitalizations with a principal discharge diagnosis of GP in 2016 and 2017. Of these patients, 78.1% (77,885) had DGP and 21.9% (21,810) were classified in the NDGP group. We noted a higher proportion of women (79.3% vs. 63.4%, P < 0.001), patients with a history of smoking (35.8% vs. 31.7%, P < 0.001) and chronic obstructive pulmonary disease (10.7% vs. 7.6%, P < 0.001) in the NDGP group. After adjusting for common confounders excluding age, the inpatient mortality for GP was found to be 0.25%. Furthermore, after adjustments were made for the Charlson comorbidity index (CCI), we noted higher odds of mortality in the NDGP group (0.30% vs. 0.23%, adjusted odds ratio (aOR): 3.18, 95% confidence interval (CI): 1.75 - 5.79, P < 0.001) compared to the DGP group. Additionally, patients with NDGP had a higher mean length of stay (5 vs. 4.1 days, P < 0.001) and higher mean total hospital charge ($44,100 vs. $35,500, P < 0.001) compared to those with DGP. The NDGP group also had higher odds of sepsis, deep vein thrombosis (DVT) and pulmonary embolism (PE); however, the odds of developing acute kidney injury (AKI) were lower than that of the DGP group. Conclusions The inpatient mortality for GP was found to be 0.25%. After adjusting for CCI, patients with NDGP had higher odds of inpatient mortality compared to the DGP group. Additionally, patients with NDGP were associated with a longer length of hospital stay, mean total healthcare cost and higher odds of complications such as sepsis, DVT and PE during the hospitalization.

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Symptoms of Autonomic Dysfunction in Human Immunodeficiency Virus

Cited by 15 publications

References 15 publications

Association between HIV and Prevalent Hypertension and Diabetes Mellitus in South Africa: Analysis of a Nationally Representative Cross-Sectional Survey

Association between HIV and Prevalent Hypertension and Diabetes Mellitus in South Africa: Analysis of a Nationally Representative Cross-Sectional Survey

Inappropriate sinus tachycardia in post-COVID-19 syndrome

Diabetic and Non-Diabetic Gastroparesis: A Retrospective Comparative Outcome Study From the Nationwide Inpatient Sample

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