Autonomic neuropathy in patients with HIV: course, impact of disease stage, and medication

Citation
T. Gluck et al., Autonomic neuropathy in patients with HIV: course, impact of disease stage, and medication, CLIN AUTON, 10(1), 2000, pp. 17-22
Citations number
36
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Neurology
Journal title
CLINICAL AUTONOMIC RESEARCH
ISSN journal
0959-9851 → ACNP
Volume
10
Issue
1
Year of publication
2000
Pages
17 - 22
Database
ISI
SICI code
0959-9851(200002)10:1<17:ANIPWH>2.0.ZU;2-8
Abstract
The purpose of this article is to examine the prevalence, degree, and natur al course of pupillary neuropathy (PANP), cardiovascular autonomic neuropat hy (CANP), and sensorimotor neuropathy (SNP) and to study the impact of dis ease stage and medication on neuropathy in 61 consecutive patients with HIV . PANP, CANP, and SNP were assessed by standardized test procedures. Overal l prevalence of PANP, CANP, and SNP were 66%, 15%, and 15%, respectively. T he maximal pupillary area (pupillary measure, p <0.0001) and the lying-to-s tanding ratio (cardiovascular measure, p <0.0001) were abnormal as compared with control subjects, The changes in CD4+ T-lymphocytes and respiratory s inus arrhythmia percentile during 2 years of follow-up correlated significa ntly (r = 0.758, p = 0.007). Patients with CANP were more often in an advan ced disease stage than patients without CANP (p = 0.004). SNP, but not PANP or CANP, was associated with the intake of the neuropathogenic drugs dideo xycytidine, dideoxyinosine, and 2',3' didehydro-2',3' dideoxythymidine (p < 0.05). Autonomic and sensorimotor neuropathy are frequent in patients with HIV, and progression of CANP may put patients at risk for unexpected cardio respiratory arrest.