Sensorimotor Neuropathy and Abnormal Vitamin B<sub>12</sub> Metabolism in Early HIV Infection

Veilleux, Martin; Paltiel, Ora; Falutz, Julian

doi:10.1017/s0317167100040488

Cited by 13 publications

(11 citation statements)

References 18 publications

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“…Other possible causes of DSPN could be related to nutrition deficits particularly lack of vitamin BI2. We cannot conclude that their DSPN was not due to vitamin B,, deficiency since serum B,, levels were not measured; although a Canadian study (18) showed no association between the frequency of occurrence of DSPN and B1, deficiency in the early stages of infection.…”

Section: Discussionmentioning

confidence: 80%

Peripheral neuropathy in individuals with HIV infection in Zimbabwe

Parry

Mielke²,

As³

et al. 2009

Acta Neurologica Scandinavica

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Peripheral neuropathy is associated with HIV infection. The prevalence and types of peripheral neuropathy encountered in a randomly‐selected HIV infected African population at different stages of disease were investigated. HIV positive individuals were categorized into 1 of 3 groups: asymptomatic, symptomatic and AIDS. HIV negative individuals formed the control group. Nerve conduction data were obtained using standard electrophysiological procedures and CD4+ levels were measured. The type of neuropathy was determined from the history, clinical presentation and electrophysiological abnormalities. The prevalence of peripheral neuropathy was 44%: subclinical neuropathy (SCN) accounted for 56%, acute inflammatory demyelinating polyneuropathy (AIDP) for 15% and distal symmetrical polyneuropathy (DSPN) for 22% of cases of neuropathy. SCN was found in all categories whereas AIDP predominated in the symptomatic category and DSPN in individuals with AIDS. The pattern and frequency of neuropathies seen in our African population is similar to that reported from other continents.

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Section: Discussionmentioning

confidence: 80%

Peripheral neuropathy in individuals with HIV infection in Zimbabwe

Parry

Mielke²,

As³

et al. 2009

Acta Neurologica Scandinavica

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“…We contacted 36 authors, of whom 13 provided additional data, while 16 potentially relevant articles were not included due to failed or implausible replies. The data were approximated from the figures or tables in nine studies 12–20 . The final analysis included 46 observational studies on B‐vitamin markers in patients with and without PN 13–57 (Tables S2–S4) and seven intervention studies with B‐vitamins in patients with PN 58–64 (Table 1 and Table S5).…”

Section: Resultsmentioning

confidence: 99%

Association between neuropathy and B‐vitamins: A systematic review and meta‐analysis

Stein

Geisel

Obeid

2021

Euro J of Neurology

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Background Peripheral neuropathy (PN) is common in patients with diseases that are in turn associated with deficiency of the B‐vitamins, and vitamin treatment has shown mixed results. Methods This systematic review and meta‐analysis studied the association between PN/pain and B‐vitamin biomarkers and investigated whether vitamin treatment can ameliorate the symptoms. PubMed and Web of Science were searched according to the study protocol. Results A total of 46 observational and seven interventional studies were identified and included in the data synthesis. The presence of PN was associated with lowered B12 levels (pooled estimate [95% CIs] = 1.51 [1.23–1.84], n = 34, Cochran Q Test I2 = 43.3%, p = 0.003) and elevated methylmalonic acid (2.53 [1.39–4.60], n = 9, I2 = 63.8%, p = 0.005) and homocysteine (3.48 [2.01–6.04], n = 15, I2 = 70.6%, p < 0.001). B12 treatment (vs. the comparators) showed a non‐significant association with symptom improvement (1.36 (0.66–2.79), n = 4, I2 = 28.9%). Treatment with B1 was associated with a significant improvement in symptoms (5.34 [1.87–15.19], n = 3, I2 = 64.6%, p = 0.059). Analysis of seven trials combined showed a non‐significant higher odds ratio for improvement under treatment with the B‐vitamins (2.58 [0.98–6.79], I2 = 80.0%, p < 0.001). Conclusions PN is associated with lowered plasma vitamin B12 and elevated methylmalonic acid and homocysteine. Overall, interventional studies have suggested that B‐vitamins could improve symptoms of PN. Available trials have limitations and generally did not investigate vitamin status prior to treatment. Well‐designed studies, especially in non‐diabetes PN, are needed. This meta‐analysis is registered at PROSPERO (ID: CRD42020144917).

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“…Six studies provided data for the proportion of patients with HIVPN that were symptomatic [27,28,39,54,79,81]. The pooled prevalence of symptomatic PN amongst patients with HIVPN was established to be 53% (95% CI: 41%–63%).…”

Section: Resultsmentioning

confidence: 99%

Human immunodeficiency virus–related peripheral neuropathy: A systematic review and meta‐analysis

Julian

Rekatsina

Shafique

et al. 2020

Euro J of Neurology

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Background and purpose Human immunodeficiency virus (HIV)‐associated neurological syndromes occur in affected individuals as a consequence of primary HIV infection, opportunistic infections, inflammation and as an adverse effect of some forms of antiretroviral treatment (ART). The aim of this systematic review was to establish the epidemiological characteristics, clinical features, pathogenetic mechanisms and risk factors of HIV‐related peripheral neuropathy (PN). Methods A systematic, computer‐based search was conducted using the PubMed database. Data regarding the above parameters were extracted. Ninety‐four articles were included in this review. Results The most commonly described clinical presentation of HIV neuropathy is the distal predominantly sensory polyneuropathy. The primary pathology in HIVPN appears to be axonal rather than demyelinating. Age and treatment with medications belonging in the nucleoside analogue reverse transcriptase class are risk factors for developing HIV‐related neuropathy. The pooled prevalence of PN in patients naïve to ARTs was established to be 29% (95% CI: 9%–62%) and increased to 38% (95% confidence interval [CI]: 29%–48%) when looking into patients at various stages of their disease. More than half of patients with HIV‐related neuropathy are symptomatic (53%, 95% CI: 41%–63%). Management of HIV‐related neuropathy is mainly symptomatic, although there is evidence that discontinuation of some types of ART, such as didanosine, can improve or resolve symptoms. Conclusions Human immunodeficiency virus–related neuropathy is common and represents a significant burden in patients’ lives. Our understanding of the disease has grown over the last years, but there are unexplored areas requiring further study.

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Sensorimotor Neuropathy and Abnormal Vitamin B₁₂ Metabolism in Early HIV Infection

Cited by 13 publications

References 18 publications

Peripheral neuropathy in individuals with HIV infection in Zimbabwe

Peripheral neuropathy in individuals with HIV infection in Zimbabwe

Association between neuropathy and B‐vitamins: A systematic review and meta‐analysis

Human immunodeficiency virus–related peripheral neuropathy: A systematic review and meta‐analysis

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Sensorimotor Neuropathy and Abnormal Vitamin B12 Metabolism in Early HIV Infection

Cited by 13 publications

References 18 publications

Peripheral neuropathy in individuals with HIV infection in Zimbabwe

Peripheral neuropathy in individuals with HIV infection in Zimbabwe

Association between neuropathy and B‐vitamins: A systematic review and meta‐analysis

Human immunodeficiency virus–related peripheral neuropathy: A systematic review and meta‐analysis

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Product

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Sensorimotor Neuropathy and Abnormal Vitamin B₁₂ Metabolism in Early HIV Infection