title: HIV neuropathy in pre-HAART patients and it's correlation with risk factors in Central India.
abstract: BACKGROUND
  Peripheral neuropathy (PN) is the most common neurological complication of human immunodeficiency virus (HIV) infection and often goes unrecognized. This ailment has a significant debilitating impact on the quality of life of HIV/acquired immunodeficiency syndrome (AIDS) patients. HIV-associated sensory neuropathy (HIV-SN) is the most common PN in HIV infected patients. In India, although HIV has emerged as a public health menace, the burden of HIV-SN has not yet been well-defined.
  
  
  METHODS
  We used the Brief Peripheral Neuropathy Screening (BPNS) tool, validated by the AIDS Clinical Trial Group (ACTG) and carried out a cross-sectional study to determine the prevalence of HIV-SN and its associated factors among highly active antiretroviral therapy (HAART) naive HIV patients. HIV-SN is defined as the presence of neuropathic symptoms and at least an abnormal perception of vibrations of a 128 Hz tuning fork on the great toe or abnormal ankle reflexes or both.
  
  
  RESULTS
  Out of 75 patients studied, 40% had clinical HIV-SN and nerve conduction study (NCS) confirmed its presence in all of them. In patients with neuropathy, the mean hemoglobin was 10.76 g/dl (P < 0.0001), mean serum albumin 2.7 g/dl (P < 0.001), mean body mass index (BMI) 17.18 kg/m 2 (P < 0.0001), and mean CD4 T-cell count was 497/μl; whereas, in patients not having neuropathy the same values were 12.81 g/dl, 3.64 g/dl, 20.22 kg/m 2 , and 678/μl, respectively. Patients recall and clinical chart review showed that, 40% had symptoms even prior to HAART initiation.
  
  
  CONCLUSIONS
  HIV-SN is more common among pre-HAART patients with low level of hemoglobin, serum albumin, BMI, and CD4 T-cell count. Hence, it is found that neuropathy can be prevented by improving immune as well as nutritional status of HIV infected patients. So, BPNS, being a simple diagnostic tool should therefore be routinely applied to screen the neuropathy, to minimize the negative impact it has on the quality of life in patients with HIV infection.
authors.affiliation: Department of Medicine, Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh, India.
authors.forename: Tribhuvan Nath
authors.initials: TN
authors.lastname: Dubey
authors.forename: Somnath Singh
authors.initials: SS
authors.lastname: Raghuvanshi
authors.forename: Himanshu
authors.initials: H
authors.lastname: Sharma
authors.forename: Rita
authors.initials: R
authors.lastname: Saxena
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000821:virology; D015995:Prevalence; D012307:Risk Factors