Comorbidity of restless legs syndrome and HIV infection

The lifetime prevalence of restless legs syndrome (RLS) is about 10 % in the general population. The association of RLS with HIV infection is unknown. We aimed to investigate the prevalence of RLS in HIV positive patients and to define predictors.

A standardized questionnaire was presented to 228 HIV infected patients of the HIV outpatient clinic at the Department of Neurology,University of Münster, Germany. 129 patients (57% recall; 15% female, 44 +/- 9 years; mean CD4(+) cell count 333 +/- 274/microl, 82% under highly active antiretroviral treatment) were included in the statistical analysis. 100 age- and sex-matched controls (20 % female, 42 +/- 13 years) were recruited from waiting relatives of surgical patients. Beside demographic and disease-specific data, the questionnaire included the diagnostic questions for RLS and the RLS severity scale by the International RLS Study Group. Diagnosis of RLS was confirmed by experienced neurologists.

33.3% of the HIV infected patients and 7% of the controls (p <0.001) fulfilled the diagnostic criteria for RLS. The mean RLS severity score was higher in HIV infected patients (19.5 +/- 7.2) than in controls (7.3 +/- 1.5; p <0.001) and correlated inversely with the CD4(+) cell count (r = -0.381; p = 0.024) and the BMI (r = -0.548; p <0.001) but not with other disease-specific factors.

HIV infected patients show a significantly higher prevalence rate for RLS than the general population. The HIV infection itself with its immunological changes and involvement of the central nervous system may predispose for a risk of RLS in HIV infected patients.