A study on peripheral neuropathy in HIV infected patients: clinicoepidemiological and electrophysiological profile

K. Gunasekaran; S. Sivakumar

doi:10.18203/2320-6012.ijrms20183881

Authors

K. Gunasekaran Department of Neurology, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamilnadu, India
S. Sivakumar Department of Neurology, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamilnadu, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20183881

Keywords:

Distal symmetric polyneuropathy, Electrophysiology, HAART, HIV infection, Peripheral neuropathy

Abstract

Background: Peripheral neuropathy is one among the commonest HIV-associated neurologic complications. The spectrum and the frequency of this complication are changing due to the introduction of new antiretroviral drugs, aging of the HIV-infected people, etc. Hence there is need for a better understanding of these complications and their pathogenesis. This study was done with the aim of finding out the risk factors, clinical characteristics and various types and patterns of peripheral neuropathy in HIV infected patients of our region.

Methods: This study was a cross sectional study conducted for about a period of one year. Patients attending the out patient department of anti retroviral therapy (ART) centre were taken for the study. Selected patients were analysed for the signs and symptoms of peripheral neuropathy and they underwent electrophysiological study.

Results: Prevalence of peripheral neuropathy in HIV infected patients in our study population was 43.3%. Peripheral neuropathy was seen more in patients with advanced clinical stage and increasing age. Distal symmetric polyneuropathy was the commonest type. Common pathological pattern of neuropathy was mixed (both axonal and demyelination) neuropathy.

Conclusions: As peripheral neuropathy is a common HIV-associated neurologic complication, large number of studies are needed to elucidate the mechanisms leading to peripheral neuropathy in HIV infected patients, which in turn will allow for the development of effective therapies that provide adequate symptomatic relief and halt or reverse the damage to the nerves.

Metrics

Metrics Loading ...

References

Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies. The Antiretroviral Therapy Cohort Collaboration. Lancet HIV. 2017;4(8):e349-e356.

Scott L. Letendre, Ronald J. Ellis, Ivan Everall, Beau Ances, et al. Neurologic Complications of HIV Disease and Their Treatment. Top HIV Med. 2009;17(2):46-56.

Morgello S, Estanislao L, Simpson D. HIV-associated distal sensory polyneuropathy in the era of highly active antiretroviral therapy: the Manhattan HIV Brain Bank. Arch Neurol. 2004;61(4):546-51.

Shahabuddin S, Badar DS, Moizuddin KM, Sami LB, Solepure AB. Normative values for nerve conduction study among healthy subjects from Aurangabad, INDIA. IJRTST. 2013;8:56-61.

Mallik A, Weir AI. Nerve conduction studies: essentials and pitfalls in practice J Neurology, Neurosurgery Psychiatry. 2005;76:ii23-ii31.

Kimura J. Electrodiagnosis in diseases of nerve and muscle: Principles and Practice. FA Davis, Philadelphia;1986:118.

Weinberg JL, Kovarik CL. The WHO clinical staging system for HIV/AIDS. Virtual Mentor. 2010 Mar 1;12(3):202-6.

Markarian Y, Wulff EA, Simpson DM. Peripheral neuropathy in HIV disease. AIDS clin care. 1998 Dec;10(12):89-91.

Ferrari S, Vento S, Monaco S, Cavallaro T, Cainelli F, Rizzuto N, et al. Human immunodeficiency virus-associated peripheral neuropathies. InMayo Clinic Proceedings 2006 Feb 1 (Vol. 81, No. 2, pp. 213-219). Elsevier.

Shankar SK, Mahadevan A, Satishchandra P, Kumar RU, Yasha TC, Santosh V, et al. Neuropathology of HIV/AIDS with an overview of the Indian scene. Indian J Med Res. 2005 Apr 1;121(4):468-88.

Tagliati M, Grinnell J, Godbold J, Simpson DM. Peripheral nerve function in HIV infection: clinical, electrophysiologic, and laboratory findings. Archives of neurology. 1999 Jan 1;56(1):84-9.

Schifitto G, McDermott M, McArthur J, Marder K, Sacktor N Epstein L. Incidence of and risk factors for HIV-associated distal sensory polyneuropathy, Neurology. 2002;58(12):1764-8.

Wulff EA, Wang AK, Simpson DM. HIV-associated peripheral neuropathy: epidemiology, pathophysiology and treatment. Drugs. 2000;59:1251-60.

Luciano CA, Pardo CA, McArthur JC. Recent developments in the HIV neuropathies. Current opinion in neurology. 2003 Jun 1;16(3):403-9.

Goodkin K, Wilkie FL, Concha M, Hinkin CH, Symes S, Baldewicz TT, et al. Aging and neuro-AIDS conditions and the changing spectrum of HIV-1-associated morbidity and mortality. J Clinical Epidemiology. 2001;54(12):S35-43.

Moyle GJ, Sadler M. Peripheral neuropathy with nucleoside antiretrovirals-risk factors, incidence and management. Drug Safety. 1998;19:481-94.

Simpson DM, Tagliati M. Nucleoside analogue-associated peripheral neuropathy in human immunodeficiency virus infection. J Acquir Immune Defic Syndr Hum Retrovirol.1995;9:153-61.

Fuller GN, Jacobs JM, Guiloff RJ. Nature and incidence of peripheral nerve syndromes in HIV infection. J Neurol Neurosurg Psychiatry. 1993;56:372-81.

Hall CD, Snyder CR, Messenheimer JA, Wilkins JW, Robertson WT, Whaley RA, et al. Peripheral neuropathy in a cohort of human immunodeficiency virus-infected patients: Incidence and relationship to other nervous system dysfunction. Archives of neurology. 1991 Dec 1;48(12):1273-4.

Garg J, Anand KS, Nath M, Kanwar S. Peripheral neuropathy in HIV infected patients. Annals of Indian Academy of Neurology, 2008;11(2):S133.

Fuller GN, Jacobs JM, Guiloff RJ. Subclinical peripheral nerve involvement in AIDS: an electrophysiological and pathological study. J Neurology, Neurosurgery Psychiatry. 1991 Apr 1;54(4):318-24.

Zanetti C, Manzano GM, Gabbai AA. The frequency of peripheral neuropathy in a group of HIV positive patients in Brazil. Arquivos de neuro-psiquiatria. 2004 Jun;62(2A):253-6.

Gastaut JL, Gastaut JA, Pellissier JF, Tapko JB, Finaud M, Delpero JR, et al. Neuropathies and HIV retrovirus infections. Revue d'electroencephalo Neurophysiol clin. 1987 Dec;17(4):425-35.

Beadles WI, Jahn A, Weigel R, Clutterbuck D. Peripheral neuropathy in HIV-positive patients at an antiretroviral clinic in Lilongwe, Malawi. Trop Doct. 2009 Apr;39(2):78-80.

Deshpande AK, Patnaik MM. Nonopportunistic neurologic manifestations of the human immunodeficiency virus: an Indian study. J International AIDS Society. 2005 Dec;7(4):2.

Maritz J, Benatar M, Dave JA, Harrison TB, Badri M, Levitt NS, et al. HIV neuropathy in South Africans: frequency, characteristics, and risk factors. Muscle & Nerve: Official J Am Associa Electrodiag Med. 2010 May;41(5):599-606.