title: Substance abuse increases the risk of neuropathy in an HIV-infected cohort.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV)-infected patients commonly develop distal symmetric polyneuropathy (DSP). Age, ethnicity, and toxic exposures may influence the risk. In this study we examined the association between substance use, antiretrovirals, ethnicity, and incident neuropathy in an HIV-infected cohort.
  
  
  METHODS
  Data were obtained from the National NeuroAIDS Tissue Consortium (NNTC), an ongoing, prospective cohort started in 1998. Cox proportional hazards models were used to examine the association of substance use, demographics, neurotoxic antiretrovirals, and laboratory parameters with incident neuropathy in 636 participants who were neuropathy-free at baseline.
  
  
  RESULTS
  The cumulative incidence of DSP was 41%. Substance use (P = 0.04), number of substances used (P = 0.04), and longer duration of HIV infection (P = 0.05) were associated with incident DSP, but demographic factors, use of neurotoxic antiretrovirals, and laboratory parameters were not.
  
  
  CONCLUSIONS
  Substance use and longer duration of HIV infection are risk factors for DSP in HIV-infected patients. Use of multiple substances may be particularly risky.
authors.affiliation: Department of Neurology, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1052, New York, New York 10029, USA. jessica.robinson-papp@mssm.edu
authors.forename: Jessica
authors.initials: J
authors.lastname: Robinson-Papp
authors.forename: Benjamin B
authors.initials: BB
authors.lastname: Gelman
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
authors.forename: Elyse
authors.initials: E
authors.lastname: Singer
authors.forename: Gary
authors.initials: G
authors.lastname: Gensler
authors.forename: Susan
authors.initials: S
authors.lastname: Morgello
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D015331:Cohort Studies; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011115:Polyneuropathies / Q000453:epidemiology* / Q000209:etiology*; D011446:Prospective Studies; D012306:Risk; D019966:Substance-Related Disorders / Q000150:complications* / Q000175:diagnosis / Q000523:psychology
chemical_list: D019380:Anti-HIV Agents