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Progression of distal-symmetric polyneuropathy in HIV infection: a prospective study
I W Husstedt1, K H Grotemeyer, H Busch
1Department of Neurology, University of Münster, Germany.
Objective:
To investigate progression of distal-symmetric sensory polyneuropathy and its correlation to immunological development.
Methods:
Clinical, neurophysiological and immunological parameters were followed in 42 HIV-infected patients for 13 +/- 6 months. Neurophysiological investigations were performed in the sural and peroneal nerve. Initially, 14 patients showed clinical signs of polyneuropathy (paresthesia, hypesthesia, diminution of vibration and deep ankle reflexes) compared with 28 patients at the end of the follow-up, 13 +/- 6 months later.
Results:
All neurophysiological parameters deteriorated during the observation period. In 20 patients changes of plasma immunoglobulin (Ig) G, IgM, IgA levels, T-helper-, T-suppressor-, natural killer cell counts and plasma beta 2-microglobulin were determined. There was a significant correlation between the development of IgG, IgM, IgA and paired stimulation and conduction velocity of the sural nerve (Spearman's rank-correlation coefficient, P < 0.05).
Conclusion:
These results show that distal-symmetric polyneuropathy during HIV infection is rapidly progressive and related to immunological factors. It is assumed that immunological mechanisms play an important part in the pathogenesis of polyneuropathy during HIV infection.