EXERCISE DYSFUNCTION IN PATIENTS SEROPOSITIVE FOR THE HUMAN-IMMUNODEFICIENCY-VIRUS

To confirm the presence of excercise dysfunction in patients seropositive for the human immunodeficiency virus (HIV), 32 such patients without AIDS were evaluated with cardiopulmonary exercise testing, pulmonary function testing, bronchoalveolar lavage, chest roentgenography, and gallium scanning. No evidence of pulmonary opportunistic infection was found. When compared to an otherwise similar group of HIV-seronegative controls, the patients exercised to a significantly lower workload (195 ± 30 versus 227 ± 31 W, p < 0.001). The ventilatory anaerobic threshold (VAT) values were also significantly lower for the patients (49.2 ± 13.0 versus 61.9 ± 9.1% of maximum predicted V̇O2, p < 0.001). Nine of the patients had VAT values less than the 95% confidence interval for the controls. This subgroup exercised to a significantly lower maximum V̇O2 (69.9 ± 11.2 versus 95.9 ± 17.5% of maximum predicted V̇O2, p < 0.001) and workload (165 ± 21 versus 227 ± 31 W) when compared to the control group. These patients demonstrated a mild tachypnea throughout exercise relative to the controls and had a significant increase in the slope of the heart rate to V̇O2 relationship. These findings are most consistent with a limitation oxygen delivery to exercising muscles, which may represent occult cardiac disease in this group.