title: Heart rate variability and heart rate turbulence in HIV-infected patients receiving combination antiretroviral therapy.
abstract: BACKGROUND
  Previous studies have demonstrated the presence of autonomic dysfunction in human immunodeficiency virus (HIV)-infected patients. However, the data in those receiving combination antiretroviral therapy (cART) are conflicting. The aim of this study was to assess the autonomic function using heart rate variability (HRV) and heart rate turbulence (HRT) analysis in HIV-infected patients receiving cART.
  
  
  METHODS
  Eighty-one HIV-infected patients receiving cART and 42 control subjects were enrolled in the study. The HRV and HRT parameters were assessed on 24-hour digital Holter electrocardiogram recordings.
  
  
  RESULTS
  Baseline characteristics were comparable between HIV-infected and control subjects, except the higher fasting glucose and triglyceride and lower high-density lipoprotein cholesterol observed in HIV-infected patients. All components of HRV were significantly reduced in HIV-infected patients. After adjustment with biochemical parameters, most of the HRV parameters were still significantly reduced in HIV-infected patients. However, HRV parameters reflecting vagal activity were no longer different between 2 groups. In addition, HRT parameters did not differ between HIV-infected and control subjects. The standard deviation of normal-to-normal intervals significantly correlated with CD4 lymphocyte counts in HIV-infected patients but did not with protease inhibitors therapy.
  
  
  CONCLUSIONS
  We demonstrated the overall decrease in HRV in HIV-infected patients receiving cART. The metabolic disturbance observed in HIV-infected patients possibly accounted for decreased vagal activity.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Cardiac Electrophysiology Research and Training Center, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Wanwarang
authors.initials: W
authors.lastname: Wongcharoen
authors.forename: Kolakrit
authors.initials: K
authors.lastname: Khienprasit
authors.forename: Arintaya
authors.initials: A
authors.lastname: Phrommintikul
authors.forename: Apichard
authors.initials: A
authors.lastname: Sukonthasarn
authors.forename: Nipon
authors.initials: N
authors.lastname: Chattipakorn
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000378:metabolism / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D001786:Blood Glucose / Q000187:drug effects; D003404:Creatinine / Q000378:metabolism; D015716:Electrocardiography, Ambulatory / Q000187:drug effects / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male
chemical_list: D044966:Anti-Retroviral Agents; D001786:Blood Glucose; D003404:Creatinine
keywords: antiretroviral therapy; autonomic dysfunction; heart rate turbulence; heart rate variability; human immunodeficiency virus
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