Frequency of neuropathy in HIV-infected adults
Y. Núñez Coronado1, P. Martínez Esteban1, M. Casapia2, S.M. Montano Torres3, J. Zunt4
1INCN, Neurology, Lima, Peru, 2Asociación Civil Selva Amazónica, Infectology, Iquitos, Peru, 3US Naval Medical Research Center Detachment, Virology Department, Lima, Peru, 4Washington University, Neurology and Global Health, Seattle, United States
Background: Peripheral neuropathy (PN) is a common complication in HIV-infected adults. The incidence of PN has declined since the introduction of highly active antiretroviral therapy (HAART), but remains an important complication of AIDS, especially in resource-poor countries.The objective was to determine the frequency of peripheral neuropathy in HIV-infected adults in Iquitos, Perú.
Methods: Cross-sectional study, the HIV-infected adults were evaluated with a detailed neurologic examination and electromyography (EMG). PN was diagnosed based in clinical and electromyographic findings.
Results: 42 HIV-infected subjects were enrolled and evaluated; the average age was 30.17 years (standard deviation 7.39 years; range 19-53), and mean duration of HIV infection was 2.68 years (S.D. 2.62 years; range 45 days - 11 years). Of these subjects, 40 (95%) were males. Evidence of PN was detected in 13 (30.95%). Specific neuropathies detected included: distal sensory polyneuropathy in 4 (9.52%), polyradiculopathy in 1 (2.38%), sural sensory neuropathy in 1 (2.38%) and small fiber neuropathy in 7 (16.67%). The most frequent signs and symptoms of PN were paresthesia in 22 subjects (52.38%), dysesthesia in 16 (38.09%) and distal sensory hypoesthesia in 14 (33.33%). The average CD4 cel count in these patients was 249.46 cells (S.D. 148.32 cells), 46.15% were in C stage of infection. Three subject (7.69%) had moderate malnutrition and 29 (69.23%) were receiving HAART.
Conclusions: PN is a common complication in HIV-infected patients. The most common form of PN was small fiber neuropathy (30.95%), which was associated with stage C infection. The most frequent signs of PN were paresthesia, dysesthesia and distal sensory hypoesthesia.
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