Screening for distal sensory peripheral neuropathy in HIV-infected persons in research and clinical settings.
OBJECTIVE
To determine the accuracy of a screening examination for distal sensory peripheral neuropathy (DSPN) performed by nonphysician clinicians and to explore the associations between DSPN and clinical features in HIV-infected persons.


METHODS
A case-control study of a volunteer sample of 226 HIV-infected individuals was performed. An interview, focusing on risks and symptoms of DSPN, and a screening neurologic examination were performed.


RESULTS
Compared with the neurologist's examinations, the clinicians' examination was sensitive (92 to 95%) but not as specific (71 to 84%) for the diagnosis of DSPN. After excluding 27 patients with confounders, 42 of 199 patients (21%) had DSPN. This was associated significantly with neurotoxic nucleoside antiretroviral use and with more advanced HIV disease. Of the 42 patients with DSPN, 30 (71%) had no neuropathy symptoms.


CONCLUSIONS
A brief examination performed by trained nonphysician clinicians can be used to screen for DSPN in HIV-infected persons. Asymptomatic DSPN is common in these individuals.
Marra
C M
CM
Department of Neurology, University of Washington, Seattle, USA.
Boutin
P
P
Collier
A C
AC
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000276:immunology; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D009460:Neurologic Examination / Q000592:standards; D009475:Neurons, Afferent / Q000502:physiology; D010525:Peripheral Nerves / Q000166:cytology / Q000821:virology; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000276:immunology / Q000821:virology*; D015203:Reproducibility of Results