Implementation of a validated peripheral neuropathy screening tool in patients receiving antiretroviral therapy in Mombasa, Kenya.
Limited objective data are available for the prevalence of peripheral neuropathy (PN) among antiretroviral (ART)-treated human immunodeficiency virus (HIV)-infected patients in resource-limited settings. A validated neuropathy-screening tool was integrated into routine ART visits at an HIV clinic in Mombasa, Kenya. Diagnosis of PN required at least one symptom and either abnormal vibratory sensation or deep tendon reflex bilaterally. Among 102 consecutively screened patients, 63% were women, 62% were receiving ART for < or = 1 year, and 86% were receiving a stavudine (D4T)-based regimen. Thirty-seven (36%) had PN. Univariate analysis showed that current D4T use was protective against PN (P = 0.03) and older age was a marginal risk factor (P = 0.05). Multivariate analysis showed that older age was a risk factor for neuropathy (P = 0.04). Peripheral neuropathy was common, particularly among older HIV-infected adults in Kenya. The protective association with current D4T use likely represents survivor effect bias. Longitudinal studies using this screen will help further characterize PN in resource-limited settings.
Mehta
Sapna A
SA
Division of Infectious Diseases, and Center for AIDS Research, Department of Medicine, New York University School of Medicine, New York, New York, USA. sapna.mehta@nyumc.org
Ahmed
Aabid
A
Kariuki
Beatrice W
BW
Said
Swaleh
S
Omasete
Fanuel
F
Mendillo
Megan
M
Laverty
Maura
M
Holzman
Robert
R
Valentine
Fred
F
Sivapalasingam
Sumathi
S
D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007630:Kenya; D008297:Male; D015999:Multivariate Analysis; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000175:diagnosis*; D012307:Risk Factors
D019380:Anti-HIV Agents
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