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Implementation of a Validated Peripheral Neuropathy Screening Tool in Patients Receiving Antiretroviral Therapy in Mombasa, Kenya

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  • Division of Infectious Diseases, and Center for AIDS Research, Department of Medicine, New York University School of Medicine, New York, New York; Bomu Medical Centre, Mombasa, Kenya
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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 (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.

Author Notes

*Address correspondence to Sapna A. Mehta, Department of Medicine, New York University School of Medicine, 545 First Avenue, Greenberg Hall, SC1-132, New York, NY 10016. E-mail: sapna.mehta@nyumc.org

Financial support: This study was supported in part by grant 1UL1RR029893 from the National Center for Research Resources, National Institutes of Health, grant P30 AI027742 from for the New York University Center for AIDS Research, and cooperative agreement 5U62PS224509-04 from the Centers for Disease Control and Prevention.

Disclosure: The contents of this report are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

Authors' addresses: Sapna A. Mehta, Megan Mendillo, Maura Laverty, Robert Holzman, and Sumathi Sivapalasingam, Department of Medicine, New York University School of Medicine, New York, NY. Aabid Ahmed, Beatrice W. Kariuki, Swaleh Said, and Fanuel Omasete, Bomu Medical Centre, Mombasa, Kenya. Fred Valentine, Center for AIDS Research and Department of Medicine, New York University School of Medicine, New York, NY.

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