title: Measures of small-fiber neuropathy in HIV infection.
abstract: BACKGROUND
  Noninvasive methods are needed to detect distal sensory polyneuropathy in HIV-infected persons on antiretroviral therapy (ART).
  
  
  METHODS
  Quantitative sudomotor axon reflex test (QSART) and Utah Early Neuropathy Scale (UENS), small-fiber sensitive measures, were assessed in subjects with and without clinical neuropathy. Pain was assessed by visual analog scale (VAS).
  
  
  RESULTS
  Twenty-two subjects had symptoms and signs of neuropathy, 19 had neither, and all were receiving ART. Median sweat volume (μL) was lower at all testing sites in those with neuropathy compared to those without (p<0.01 for all). UENS and VAS (mm) were higher in neuropathy subjects (p<0.05 for each). Lower sweat volume at all sites correlated with higher pin UENS subscore, total UENS, and VAS (p<0.05 for all). In multivariable analyses adjusting for age, CD4⁺ T cells, sex, and use of "d-drug" ART, QSART and UENS remained associated (p=0.003).
  
  
  CONCLUSIONS
  QSART and UENS have not been previously studied in this patient population and may identify small-fiber neuropathy in HIV-infected, ART-treated persons.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC 29412, United States. bogerm@musc.edu
authors.forename: M S
authors.initials: MS
authors.lastname: Boger
authors.forename: T
authors.initials: T
authors.lastname: Hulgan
authors.forename: D W
authors.initials: DW
authors.lastname: Haas
authors.forename: V
authors.initials: V
authors.lastname: Mitchell
authors.forename: A G
authors.initials: AG
authors.lastname: Smith
authors.forename: J R
authors.initials: JR
authors.lastname: Singleton
authors.forename: A C
authors.initials: AC
authors.lastname: Peltier
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001369:Axons / Q000187:drug effects; D015331:Cohort Studies; D003943:Diagnostic Techniques, Neurological; D042241:Early Diagnosis; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000175:diagnosis* / Q000503:physiopathology; D010147:Pain Measurement; D010523:Peripheral Nervous System Diseases / Q000209:etiology*; D011115:Polyneuropathies / Q000209:etiology*; D011446:Prospective Studies; D012018:Reflex / Q000187:drug effects; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D013546:Sweating / Q000187:drug effects
chemical_list: D044966:Anti-Retroviral Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors