Risk modifiers for peripheral sensory neuropathy in HIV infection/AIDS

The objective of this study is to examine the risk factors associated with the development of sensory neuropathy in human immunodeficiency virus (HIV)-infected patients in 292 HIV+ patients recruited through a community-based sentinel survey. We determined the clinical and treatment factors associated with the presence of peripheral sensory neuropathy in HIV+ subjects at baseline examination, and at 1-year follow-up. Baseline examination was assessed with a logistic regression analysis controlling for age, education level, history of drug/alcohol use, and anti-retroviral treatment. The risk of developing new peripheral neuropathy at follow-up was determined using a Cox proportional hazard model analysis. At study entry, neuropathy (n=64) was associated with acquired immunodeficiency syndrome (AIDS), nucleoside analogue reverse transcriptase inhibitors (NRTI) (i.e. ddC), and history of alcohol abuse. After 1-year follow-up, the development of neuropathy was predicted by AIDS, age (older subjects), and NRTI use. These findings indicated that AIDS, age, alcohol abuse/dependence, and anti-retroviral medication use are important predictors of motor/sensory peripheral neuropathy in the HIV infection. The peripheral neurotoxic effect of anti-retroviral medication should be taken into account in the design of long-term therapies.