The roles of ethnicity and antiretrovirals in HIV-associated polyneuropathy: a pilot study.
BACKGROUND
In the pre-highly active antiretroviral therapy (HAART) era, distal sensory polyneuropathy (DSP) was associated with markers of advanced HIV infection and the use of neurotoxic antiretrovirals (ARVs). As HAART became widespread, and the AIDS epidemic shifted into minority populations, the risk factors for DSP became less clear. We explore the roles of ethnicity and ARV in the development of DSP in an HAART era cohort.


METHODS
Data from 336 HIV-positive adults were obtained from the Manhattan HIV Brain Bank. One hundred four participants had no DSP at entry visit; at least 1 follow-up visit; and a self-identified ethnicity of non-Hispanic white, Hispanic, or African American.


RESULTS
Fifty percent of participants developed DSP; of those, 67% were symptomatic. Participants who developed DSP were older (P = 0.02) and had higher CD4 counts (P = 0.001). ARV-DSP was more common in Hispanics (P = 0.02) and intravenous drug users (P = 0.02). There was a trend for higher pain scores in Hispanics with symptomatic DSP (P = 0.08).


CONCLUSIONS
This study suggests that there are ethnic disparities in the clinical manifestations of HIV-related neuropathies including pain and the susceptibility to ARV-DSP. Further studies of larger cohorts are indicated to explore the etiology of these differences.
Robinson-Papp
Jessica
J
Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029, USA. jessica.robinson-papp@mssm.edu
Gonzalez-Duarte
Alejandra
A
Simpson
David M
DM
Rivera-Mindt
Monica
M
Morgello
Susan
S
D000328:Adult; D001741:Black or African American; D019380:Anti-HIV Agents / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D010865:Pilot Projects; D011115:Polyneuropathies / Q000139:chemically induced / Q000209:etiology*; D044465:White People
D019380:Anti-HIV Agents