Peripheral neuropathy in people living with human immunodeficiency virus and acquired immunodeficiency syndrome on antiretroviral therapy

Authors

  • Joshua L Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004
  • Medo M. Kuotsu Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004
  • Nyamnyei Konyak Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004
  • Ksh Birendra Singh Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004
  • N. Biplab Singh Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004
  • Labresai Mog Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004
  • Senjele Kath Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004
  • Japheth Thono Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004

DOI:

https://doi.org/10.18203/2349-3933.ijam20213707

Keywords:

Peripheral neuropathy, ART, Duration, Protease inhibitor

Abstract

Background: Peripheral neuropathy is a common neurological complication in people with human immunodeficiency virus (HIV) infection. HIV-associated sensory neuropathy (HIV-SN) is defined as the presence of neuropathic symptoms and at least an abnormal perception of vibrations of a 128 Hz tuning fork on the great toe or abnormal ankle reflexes or both. Brief peripheral neuropathy screening (BPNS) tool is employed in identifying HIV-SN based on a directed symptom questionnaire and limited clinical examination. The present study was conducted to determine the prevalence and drug regimens related to peripheral neuropathy in people living with HIV and Acquired immunodeficiency syndrome (AIDS) on antiretroviral therapy (ART) so as to help improve the care for those on ART. The objective was to study the prevalence of peripheral neuropathy in people living with HIV and AIDS on ART using AIDS clinical trials group validated BPNS tools.

Methods: Cross-sectional study on 198 HIV-seropositive cases aged above 18 years on ART attending centre of excellence (CoE) ART centre, RIMS Imphal. The presence of peripheral neuropathy was examined by using a BPNS among the participants.

Results: Peripheral neuropathy was found in 46 (23.2%) out of 198 participants using BPNS. In this study a positive association between the duration of treatment with ART and use of protease inhibitor regimes with the development of peripheral neuropathy was significant.

Conclusions: Peripheral neuropathy in patient with HIV and AIDS on ART had significant association with duration of treatment with ART and use of protease inhibitor combination in the ART regime. 

Author Biographies

Joshua L, Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004

Post Graduate Trainee, Department of Medicine, Regional Institute of Medical Sciences, Imphal

Medo M. Kuotsu, Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004

Post Graduate Trainee, Department of Medicine, Regional Institute of Medical Sciences, Imphal

Nyamnyei Konyak, Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004

Post Graduate Trainee, Department of Medicine, Regional Institute of Medical Sciences, Imphal

Ksh Birendra Singh, Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004

Professor, Department of Medicine, Regional Institute of Medical Sciences, Imphal

N. Biplab Singh, Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004

Professor, Department of Medicine, Regional Institute of Medical Sciences, Imphal

Labresai Mog, Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004

Post Graduate Trainee, Department of Medicine, Regional Institute of Medical Sciences, Imphal

Senjele Kath, Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004

Post Graduate Trainee, Department of Medicine, Regional Institute of Medical Sciences, Imphal

Japheth Thono, Department of Medicine, Regional Institute of Medical Sciences, Imphal-795004

Post Graduate Trainee, Department of Medicine, Regional Institute of Medical Sciences, Imphal

References

Cornblath DR, Hoke A. Recent advances in HIV neuropathy. Curr Opin Neurol. 2006,19(5):446-50.

Cherry CL, Affandi JS, Imran D, Yunihastuti E, Smyth K, Vanar S, et al. Age and height predict neuropathy risk in patients with HIV prescribed stavudine. Neurology. 2009;73(4):315-20.

Gonzalez D, Robinson PJ, Simpson DM. Diagnosis and management of HIV-associated neuropathy. Neurol Clin. 2008;26(3):821-32.

Evans SR, Ellis RJ, Chen H, Yeh T, Lee AJ, Schifitto G, et al. Peripheral neuropathy in HIV: prevalence and risk factors. AIDS. 2011;25(7):919-28.

Maritz J. Benatar M, Dave JA, Harrison TB, Badri M, Levitt NS, et al. HIV neuropathy in South Africans: frequency, characteristics, and risk factors. Muscle Nerve. 2010;41(5):599-606.

Kamerman PR, Moss PJ, Weber J, Wallace VC, Rice AS, Huang W. Pathogenesis of HIV-associated sensory neuropathy: evidence from in vivo and in vitro experimental models. J Peripher Nerv Syst. 2012;17(1):19-23.

Wulff EA, Wang AK, Simpson DM. HIV-associated peripheral neuropathy: epidemiology, pathophysiology and treatment. Drugs. 2000;59(6):1251-60.

Skopelitis EE, Kokotis PI, Kontos AN, Panayiotakopoulos GD, Konstantinou K, Kordossis T, et al. Distal sensory polyneuropathy in HIV-positive patients in the HAART era: an entity underestimated by clinical examination. Int J STD AIDS. 2006;17(7):467-72.

Tumusiime DK, Venter F, Musenge E, Stewart A. Prevalence of peripheral neuropathy and its associated demographic and health status characteristics, among people on antiretroviral therapy in Rwanda. BMC Pub Health. 2014;14:1306.

Robinson-Papp J, Gelman BB, Grant I, Singer E, Gensler G, Morgello S. Substance abuse increases the risk of neuropathy in an HIV-infected COHORT. Muscle Nerve. 2012;45(4):471-6.

Chauhan NS, Shah SP, Desai MK, Shah A. A safety analysis of different drug regimens used in human immunodeficiency virus-positive patients. Ind J Sex Transm Dis AIDS. 2018;2(39):84-90.

Pettersen JA, Jones G, Worthington C, Krentz HB, Keppler OT, Hoke A, et al. Sensory neuropathy in human immunodeficiency virus/acquired immunodeficiency syndrome patients: protease inhibitor-mediated neurotoxicity. Ann Neurol. 2006;59:816-24.

Downloads

Published

2021-09-22

Issue

Section

Original Research Articles