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Symptoms of Autonomic Dysfunction in HIV-Infected Patients Receiving Stable ART: "The biggest difference was seen within the male sexual dysfunction domain with 47% of the HIV group experiencing symptoms, compared to 11% of the control group experiencing symptoms"
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Reported by Jules Levin
CROI 2013
D Chow*1, K Sullivan1, D Sletten2, M Kocher1,
R Romine1, B Nakamoto1,3, T Umaki1, K Kallianpur1 , C Shikuma1 , P Low2 1Hawaii Center for AIDS, Department of Medicine, University of Hawaii, Honolulu, HI, USA; 2Mayo Clinic, Rochester, MN, USA; 3Straub Medical Center, Honolulu, HI, USA
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Dysautonomia (or autonomic dysfunction) is any disease or malfunction of the autonomic nervous system (ANS). The autonomic nervous system controls a number of functions in the body, such as heart rate, blood pressure, digestive tract peristalsis, and sweating, amongst others. Dysfunction of the ANS can involve any of these functions......mitochondrial diseases can be a cause......The outlook for patients with dysautonomia depends on the particular diagnostic category. Some forms of dysautonomia resolve over time and are not life threatening, even if life-changing in the form of minor to major limitations in activities of daily living. Patients with chronic, progressive, generalized dysautonomia in the setting of central nervous system degeneration have a generally poor long-term prognosis. Death can occur from pneumonia, acute respiratory failure, or sudden cardiopulmonary arrest in such patients
http://en.wikipedia.org/wiki/Dysautonomia
The symptoms of dysautonomia are numerous and vary widely from person to person. Since dysautonomia is a full-body condition, a large number of symptoms may be present that can greatly alter a person's quality of life. Each patient with dysautonomia is different-some are affected only mildly, while others are left completely bed-ridden and disabled.
The primary symptoms present in patients with dysautonomia are:
· Excessive fatigue
· Excessive thirst (polydipsia)
· Lightheadedness, dizziness or vertigo
· Feelings of anxiety or panic (not mentally induced[citation needed])
· Rapid heart rate or slow heart rate
· Orthostatic hypotension, sometimes resulting in syncope[1] (fainting)
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· The upper limit for normal COMPASS score was defined as the mean +1SD of the control group scores (30.8).
· 40% of the HIV group had a total COMPASS score of ³30, indicative of autonomic dysfunction.
- Only 9% of the control group had a total COMPASS score of 30 or higher.
· The HIV group experienced more symptoms of autonomic dysfunction, than did the control group.
· The most common symptoms of autonomic dysfunction experienced within the HIV group were those of secretomotor and pupillomotor, with 58% and 60% respectively, of subjects reporting symptoms.
· The HIV group demonstrated a higher percentage of subjects experiencing symptoms of autonomic dysfunction in 10 of the 11 domains when compared to the control group.
· The biggest difference was seen within the male sexual dysfunction domain with 47% of the HIV group experiencing symptoms, compared to 11% of the control group experiencing symptoms.
· The domain with the second biggest difference between groups was that of secretomotor, with 58% of the HIV group experiencing symptoms and 26% of the control group experiencing symptoms
· Of the 33 HIV-positive participants who had a CASS score to report, 43% were categorized as having mild autonomic dysfunction and 6% were boarding on moderate autonomic dysfunction.
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