Measures of small-fiber neuropathy in HIV infection.

Boger MS, Hulgan T, Haas DW, Mitchell V, Smith AG, Singleton JR, Peltier AC
Auton Neurosci. 2012 169 (1): 56-61

PMID: 22542355 · PMCID: PMC3372978 · DOI:10.1016/j.autneu.2012.04.001

INTRODUCTION - Noninvasive methods are needed to detect distal sensory polyneuropathy in HIV-infected persons on antiretroviral therapy (ART).

METHODS - Quantitative sudomotor axon reflex test (QSART) and Utah Early Neuropathy Scale (UENS), small-fiber sensitive measures, were assessed in subjects with and without clinical neuropathy. Pain was assessed by visual analog scale (VAS).

RESULTS - Twenty-two subjects had symptoms and signs of neuropathy, 19 had neither, and all were receiving ART. Median sweat volume (μL) was lower at all testing sites in those with neuropathy compared to those without (p<0.01 for all). UENS and VAS (mm) were higher in neuropathy subjects (p<0.05 for each). Lower sweat volume at all sites correlated with higher pin UENS subscore, total UENS, and VAS (p<0.05 for all). In multivariable analyses adjusting for age, CD4⁺ T cells, sex, and use of "d-drug" ART, QSART and UENS remained associated (p=0.003).

CONCLUSION - QSART and UENS have not been previously studied in this patient population and may identify small-fiber neuropathy in HIV-infected, ART-treated persons.

Copyright © 2012 Elsevier B.V. All rights reserved.

MeSH Terms (20)

Adult Anti-Retroviral Agents Axons Cohort Studies Diagnostic Techniques, Neurological Early Diagnosis Female HIV Infections HIV Protease Inhibitors Humans Male Middle Aged Neurotoxicity Syndromes Pain Measurement Peripheral Nervous System Diseases Polyneuropathies Prospective Studies Reflex Reverse Transcriptase Inhibitors Sweating

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