Risk modifiers for peripheral sensory neuropathy in HIV infection/AIDS

Abstract

The objective of this study is to examine the risk factors associated with the development of sensory neuropathy in human immunodeficiency virus (HIV)-infected patients in 292 HIV+ patients recruited through a community-based sentinel survey. We determined the clinical and treatment factors associated with the presence of peripheral sensory neuropathy in HIV+ subjects at baseline examination, and at 1-year follow-up. Baseline examination was assessed with a logistic regression analysis controlling for age, education level, history of drug/alcohol use, and anti-retroviral treatment. The risk of developing new peripheral neuropathy at follow-up was determined using a Cox proportional hazard model analysis. At study entry, neuropathy (n=64) was associated with acquired immunodeficiency syndrome (AIDS), nucleoside analogue reverse transcriptase inhibitors (NRTI) (i.e. ddC), and history of alcohol abuse. After 1-year follow-up, the development of neuropathy was predicted by AIDS, age (older subjects), and NRTI use. These findings indicated that AIDS, age, alcohol abuse/dependence, and anti-retroviral medication use are important predictors of motor/sensory peripheral neuropathy in the HIV infection. The peripheral neurotoxic effect of anti-retroviral medication should be taken into account in the design of long-term therapies.

Prevalence, incidence and predictors of peripheral neuropathy in African adults with HIV infection within the DART trial

“…However, as above, overall, we observed a lower post-ART peripheral neuropathy incidence than more recent studies in Africa [22,23,32,33] and one USA study [34].…”

Sensory neuropathy in human immunodeficiency virus/acquired immunodeficiency syndrome patients: Protease inhibitor–mediated neurotoxicity

“…25 Indeed, age is a risk factor for other neurological manifestations of HIV-1, including HIV-associated dementia and its antecedent condition (Minor Cognitive-Motor Deficit), together with progressive multifocal leukoencephalopathy, primary central nervous system lymphoma, and stroke. 24 Previous studies have re- ported either a positive association between alcohol consumption and the development of HIV-SN 26,28 or no alcohol effects 29 ; thus, it appears counterintuitive that alcohol use was more prevalent among those without HIV-SN in this study. Conversely, alcohol has been shown to inhibit neuronal injury in models of HIV gp120 neurotoxicity.…”

Ascending Paralysis Associated with Hiv Infection

“…HIV-associated distal sensory polyneuropathy (also called predominantly sensory neuropathy, or distal symmetrical peripheral neuropathy) is the most common neurological problem in AIDS, with variable incidences in diff erent reports ranging from 19% to 66% (6,7). Th e risk factors for HIV-associated distal sensory polyneuropathy are older age, history of alcohol abuse, advanced HIV disease, prior use of a neurotoxic antiretroviral drug, and diabetes mellitus (8,9). Infl ammatory demyelinating neuropathy, on the other hand, is less common and can occur at various stages of the disease, requiring diff erent therapeutic approaches.…”