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Highly active antiretroviral therapy is linked to increased sensory neuropathies in Human Immunodeficiency Virus (HIV) patients. Stavudine regimens and age over 40 significantly increase symptomatic neuropathy risk.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Clinical Electrophysiology

Background:

  • Sensory neuropathies are increasingly prevalent in the era of highly active antiretroviral therapy (HAART).
  • Understanding the frequency and characteristics of Human Immunodeficiency Virus (HIV)-associated neuropathies is crucial.
  • Differentiating between the two most common forms of sensory neuropathy requires detailed clinicoelectrophysiological analysis.

Purpose of the Study:

  • To document the frequency and profile of the two most common sensory neuropathies in HIV-infected patients.
  • To investigate the clinicoelectrophysiological correlates for differentiating these neuropathies.
  • To assess the relationship between antiretroviral therapy, CD4 counts, age, and neuropathy development.

Main Methods:

  • Retrospective analysis of 50 consecutive HIV-positive patients attending a Neurology outpatient department (March 2011-March 2012).
  • Data collection included patient records (CD4 counts, treatment details) and interviews.
  • All patients underwent comprehensive clinical examination and nerve conduction studies (NCSs).

Main Results:

  • Symptomatic neuropathy was more common in patients on antiretroviral therapy (ART), particularly those on stavudine regimens within one year.
  • Patients over 40 years old had a higher likelihood of symptomatic neuropathy.
  • Impaired vibration sensation and absent ankle jerks were prevalent; axonal neuropathy was common in ART patients, while demyelinating neuropathy occurred in non-ART patients.
  • Subclinical neuropathy (abnormal NCS) was frequent in asymptomatic patients on ART.

Conclusions:

  • Symptomatic neuropathy is predominantly observed in HIV patients undergoing ART.
  • Stavudine-containing regimens are associated with severe symptomatic neuropathy within a year.
  • Age over 40 is a risk factor for symptomatic neuropathy.
  • Subclinical neuropathy is common among patients on ART, irrespective of CD4 count.
  • Axonal neuropathy is the most frequent type in ART patients, contrasting with demyelinating neuropathy in non-ART patients.