Microcirculatory disturbances in AIDS patients--a first report.

The aim of this study is to explore the vascular perturbations associated with AIDS infections as a means of developing strategies to help in the treatment of these patients. Closed-circuit television microscopic observation of the microcirculation in the nail fold was carried out on 11 AIDS patients and 11 healthy European adults. A striking pattern of severe microvascular disturbances was demonstrated in these patients: (i) a suppression of the spontaneous, rhythmic adjustments of capillary blood perfusion, and (ii) damage to the endothelium of the capillary wall. These findings suggest a substantial involvement of the microcirculation in the pathogenetic development of the AIDS syndrome, as well as a close relationship between microvascular perfusion and the immune condition of the organism. The data indicate that the treatment of the AIDS patient should be directed not only toward the inhibition or killing of the virus, but also toward the improvement of microcirculatory perfusion.