Risk modifiers for peripheral sensory neuropathy in HIV infection/AIDS.
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.
Lopez
O L
OL
Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, PA, USA. lopezol@msx.upmc.edu
Becker
J T
JT
Dew
M-A
MA
Caldararo
R
R
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy*; D000328:Adult; D044966:Anti-Retroviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000209:etiology*; D016016:Proportional Hazards Models; D012307:Risk Factors
D044966:Anti-Retroviral Agents