1921
Volume 83, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

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 ≤ 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 ( 0.03) and older age was a marginal risk factor ( = 0.05). Multivariate analysis showed that older age was a risk factor for neuropathy ( = 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.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2010.09-0629
2010-09-01
2017-09-19
Loading full text...

Full text loading...

/deliver/fulltext/14761645/83/3/565.html?itemId=/content/journals/10.4269/ajtmh.2010.09-0629&mimeType=html&fmt=ahah

References

  1. Ferrari S, Vento S, Monaco S, Cavallaro T, Cainelli F, Rizzuto N, Temesgen Z, , 2006. Human immunodeficiency virus-associated peripheral neuropathies. Mayo Clin Proc 81: 213219.[Crossref]
  2. Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach. Available at: http://www.who.int/hiv/pub/guidelines/artadultguidelines.pdf. Accessed June 2, 2010.
  3. Boulle A, Orrel C, Kaplan R, Van Cutsem G, McNally M, Hilderbrand K, Myer L, Egger M, Coetzee D, Maartens G, Wood R, , 2007. Substitutions due to antiretroviral toxicity or contraindication in the first 3 years of antiretroviral therapy in a large South African cohort. Antivir Ther 12: 753760.
  4. Forna F, Liechty CA, Solberg P, Asiimwe F, Were W, Mermin J, Behumbiize P, Tong T, Brooks JT, Weidle PJ, , 2007. Clinical toxicity of highly active antiretroviral therapy in a home-based AIDS care program in rural Uganda. J Acquir Immune Defic Syndr 44: 456462.[Crossref]
  5. Hawkins C, Achenbach C, Fryda W, Ngare D, Murphy R, , 2007. Antiretroviral durability and tolerability in HIV-infected adults living in urban Kenya. J Acquir Immune Defic Syndr 45: 304310.
  6. Hoffmann CJ, Fielding KL, Charalambous S, Sulkowski MS, Innes C, Thio CL, Chaisson RE, Churchyard GJ, Grant AD, , 2008. Antiretroviral therapy using zidovudine, lamivudine, and efavirenz in South Africa: tolerability and clinical events. AIDS 22: 6774.[Crossref]
  7. Millogo A, Lankoande D, Yameogo I, Yameogo AA, Sawadogo AB, , 2008. Polyneuropathies in patients treated with HAART in Bobo-Dioulasso hospital, Burkina Faso [in French]. Bull Soc Pathol Exot 101: 1113.
  8. van Oosterhout JJ, Bodasing N, Kumwenda JJ, Nyirenda C, Mallewa J, Cleary PR, de Baar MP, Schuurman R, Burger DM, Zijlstra EE, , 2005. Evaluation of antiretroviral therapy results in a resource-poor setting in Blantyre, Malawi. Trop Med Int Health 10: 464470.[Crossref]
  9. Wester CW, Kim S, Bussmann H, Avalos A, Ndwapi N, Peter TF, Gaolathe T, Mujugira A, Busang L, Vanderwarker C, Cardiello P, Johnson O, Thior I, Mazonde P, Moffat H, Essex M, Marlink R, , 2005. Initial response to highly active antiretroviral therapy in HIV-1C-infected adults in a public sector treatment program in Botswana. J Acquir Immune Defic Syndr 40: 336343.[Crossref]
  10. Cherry CL, Wesselingh SL, Lal L, McArthur JC, , 2005. Evaluation of a clinical screening tool for HIV-associated sensory neuropathies. Neurology 65: 17781781.[Crossref]
  11. Simpson DM, Kitch D, Evans SR, McArthur JC, Asmuth DM, Cohen B, Goodkin K, Gerschenson M, So Y, Marra CM, Diaz-Arrastia R, Shriver S, Millar L, Clifford DB, , 2006. HIV neuropathy natural history cohort study: assessment measures and risk factors. Neurology 66: 16791687.[Crossref]
  12. WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children. Available at: http://www.who.int/hiv/pub/guidelines/HIVstaging150307.pdf. Accessed June 2, 2010.
  13. Maritz J, Benatar M, Dave JA, Harrison TB, Badri M, Levitt NS, Heckmann JM, , 2010. HIV neuropathy in South Africans: frequency, characteristics, and risk factors. Muscle Nerve 41: 599606.
  14. Wadley A, Price P, George J, Affandi J, Smith K, Kamerman P, , eds. 2009. HIV-Associated Sensory Neuropathy: A Comparison of Rates and Risk Factors in Australia and South Africa. 5th IAS Conference on HIV Pathogenesis, Treatment and Prevention, July 19–22, 2009, Cape Town, South Africa.
  15. Cherry CL, Affandi JS, Imran D, Yunihastuti E, Smyth K, Vanar S, Kamarulzaman A, Price P, , 2009. Age and height predict neuropathy risk in patients with HIV prescribed stavudine. Neurology 73: 315320.[Crossref]
  16. Keiser O, Anastos K, Schechter M, Balestre E, Myer L, Boulle A, Bangsberg D, Toure H, Braitstein P, Sprinz E, Nash D, Hosseinipour M, Dabis F, May M, Brinkhof MW, Egger M, , 2008. Antiretroviral therapy in resource-limited settings 1996 to 2006: patient characteristics, treatment regimens and monitoring in sub-Saharan Africa, Asia and Latin America. Trop Med Int Health 13: 870879.[Crossref]
  17. Arrighi HM, Hertz-Picciotto I, , 1994. The evolving concept of the healthy worker survivor effect. Epidemiology 5: 189196.[Crossref]
  18. Gonzalez-Duarte A, Robinson-Papp J, Simpson DM, , 2008. Diagnosis and management of HIV-associated neuropathy. Neurol Clin 26: 821832.[Crossref]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2010.09-0629
Loading
/content/journals/10.4269/ajtmh.2010.09-0629
Loading

Data & Media loading...

  • Received : 19 Oct 2009
  • Accepted : 14 May 2010

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error