Effects of antiretroviral therapy on autonomic function in early HIV infection: A preliminary report

Dominic Chow, Morgan Kocher, Cecilia Shikuma, Nisha Parikh, Andrew Grandinetti, Beau Nakamoto, Todd Seto, Phillip Anson Low

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: A prospective study was conducted in human immunodeficiency virus (HIV)-infected patients as they undergo alterations in their antiretroviral therapy (ART) to determine the effect of ART on autonomic function. Methods: HIV-infected subjects who were either 1) naïve to ART and initiating ART, or 2) receiving ART and in HIV virologic failure for at least 4 months and were about to switch ART were enrolled in this study. Autonomic function assessment (cardiovagal, adrenergic, and sudomotor tests) was performed prior to and 4 months after initiating the new ART. Changes in clinical autonomic symptoms and virologic assessment were assessed. Results: Twelve subjects completed the study: 92% male; median age (Q1, Q3) was 41.0 (28.0, 48.2) years; and 50% White/Non-Hispanic. Seventy-five percent were ART naïve while 25% were failing their ART regimen. The median CD4 count was 336.5 (245.3, 372.3) cells/mm 3. All subjects achieved an undetectable HIV viral load by the 4-month follow-up visit. The majority of naïve subjects were started on an ART regimen of tenofovir/emtricitabine/ efavirenz. There were no significant differences in autonomic function assessment, as measured by cardiovagal, adrenergic, and sudomotor tests, with regards to ART initiation. Conclusion: This is the first study to examine the effects of initiating ART on autonomic function in early HIV infection. This study found no appreciable differences of ART on the autonomic nervous system when ART is initiated early in the course of HIV disease. ART may not contribute to short-term changes in autonomic function.

Original languageEnglish (US)
Pages (from-to)397-405
Number of pages9
JournalInternational Journal of Medical Sciences
Volume9
Issue number5
DOIs
StatePublished - Jul 17 2012

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Virus Diseases
HIV
Therapeutics
Tenofovir
efavirenz
Adrenergic Agents
Symptom Assessment
Autonomic Nervous System
CD4 Lymphocyte Count
Viral Load

Keywords

  • Antiretroviral therapy
  • Autonomic function
  • HIV

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effects of antiretroviral therapy on autonomic function in early HIV infection : A preliminary report. / Chow, Dominic; Kocher, Morgan; Shikuma, Cecilia; Parikh, Nisha; Grandinetti, Andrew; Nakamoto, Beau; Seto, Todd; Low, Phillip Anson.

In: International Journal of Medical Sciences, Vol. 9, No. 5, 17.07.2012, p. 397-405.

Research output: Contribution to journalArticle

Chow, Dominic ; Kocher, Morgan ; Shikuma, Cecilia ; Parikh, Nisha ; Grandinetti, Andrew ; Nakamoto, Beau ; Seto, Todd ; Low, Phillip Anson. / Effects of antiretroviral therapy on autonomic function in early HIV infection : A preliminary report. In: International Journal of Medical Sciences. 2012 ; Vol. 9, No. 5. pp. 397-405.
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abstract = "Background: A prospective study was conducted in human immunodeficiency virus (HIV)-infected patients as they undergo alterations in their antiretroviral therapy (ART) to determine the effect of ART on autonomic function. Methods: HIV-infected subjects who were either 1) na{\"i}ve to ART and initiating ART, or 2) receiving ART and in HIV virologic failure for at least 4 months and were about to switch ART were enrolled in this study. Autonomic function assessment (cardiovagal, adrenergic, and sudomotor tests) was performed prior to and 4 months after initiating the new ART. Changes in clinical autonomic symptoms and virologic assessment were assessed. Results: Twelve subjects completed the study: 92{\%} male; median age (Q1, Q3) was 41.0 (28.0, 48.2) years; and 50{\%} White/Non-Hispanic. Seventy-five percent were ART na{\"i}ve while 25{\%} were failing their ART regimen. The median CD4 count was 336.5 (245.3, 372.3) cells/mm 3. All subjects achieved an undetectable HIV viral load by the 4-month follow-up visit. The majority of na{\"i}ve subjects were started on an ART regimen of tenofovir/emtricitabine/ efavirenz. There were no significant differences in autonomic function assessment, as measured by cardiovagal, adrenergic, and sudomotor tests, with regards to ART initiation. Conclusion: This is the first study to examine the effects of initiating ART on autonomic function in early HIV infection. This study found no appreciable differences of ART on the autonomic nervous system when ART is initiated early in the course of HIV disease. ART may not contribute to short-term changes in autonomic function.",
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