Impairment of exercise capacity in various groups of HIV-infected patients

Abstract

It is known that pulmonary function is impaired during the course of HIV infection even in early stages. In order to estimate the resulting reduction of exercise capacity, different groups of HIV patients were investigated. Group 1 consisted of 20 patients without a history of respiratory disease and without actual lung disease, group 2 of 18 patients with a former episode of Pneumocystis carinii pneumonia (PCP) without actual lung disease, and group III of 37 patients with different broncho-pulmonary complications including PCP. 20 normal subjects served as controls. Spirometry, diffusing capacity (DLCO) and exercise tests including arterial blood gas analysis (BGA) were performed in patients and controls. Compared to the controls group 1 patients revealed a decreased DLCO (TCO: 83 +/- 15 vs. 67 +/- 15% pred.norm.) while spirometric data were normal. VO2 and O2 pulse at the anaerobic threshold (17.7 +/- 5.1 vs. 14.3 +/- 2.6 ml/kg.min and 10.8 +/- 4.0 vs. 8.6 +/- 1.9 ml/beat, respectively) and maximum exercise (33.9 +/- 9.7 vs. 22.1 +/- 3.4 ml/kg.min and 15.0 +/- 5.0 vs. 11.3 +/- 2.5, respectively) were decreased, whereas AaDO2, VD/VT, and the HR/VO2 slope were normal. The reserves of heart rate and ventilation were high. Except for a reduced maximum work rate in group 1, no significant difference was found between groups 1 and 2. Group 3 patients differed most from groups 1 and 2 with respect to spirometry, DLCO and AaDO2, rather than VO2.(ABSTRACT TRUNCATED AT 250 WORDS)