Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
J Pain Symptom Manage. 2011 Apr;41(4):700-6. doi: 10.1016/j.jpainsymman.2010.07.006. Epub 2010 Dec 8.
HIV-associated sensory neuropathy (HIV-SN) is a frequent complication of both HIV and neurotoxic antiretroviral medications such as stavudine.
To determine the prevalence, risk factors, and clinical characteristics of symptomatic HIV-SN in a Black South African cohort of patients exposed to stavudine.
HIV-positive Black South Africans (n=395) who had received stavudine for at least six months were recruited at the Virology Clinic of the Charlotte Maxeke Academic Johannesburg Hospital, South Africa, and screened for neuropathy using the AIDS Clinical Trials Group neuropathy screening tool. HIV-SN was defined as present if the patient had both symptoms and signs of peripheral neuropathy. If present, the distribution and intensity of symptoms were recorded. In addition, anthropomorphic, demographic, and clinical information were recorded and analyzed as risk factors.
The prevalence of symptomatic HIV-SN was 57% (226 of 395). Increasing age and height were independently associated with the development of SN among patients who had used stavudine. Pain was the primary symptom reported by participants with HIV-SN (76%, 172 of 226), followed by numbness (48%, 108 of 226), and pins and needles (46%, 105 of 226). About three-quarters of participants rated their symptoms as being of moderate to severe intensity. Symptoms were always present in the feet and only 23% experienced symptoms proximal to the feet.
HIV-SN was common in this population and frequently associated with moderate to severe pain in the feet. HIV-SN was significantly associated with increasing age and height, factors that could be measured at no added cost prior to stavudine prescription, allowing higher risk patients to be offered priority access to nonneurotoxic drugs.
HIV 相关感觉神经病变（HIV-SN）是 HIV 和神经毒性抗逆转录病毒药物（如司他夫定）的常见并发症。
在接受司他夫定治疗的南非黑人队列中，确定有症状的 HIV-SN 的患病率、危险因素和临床特征。
在南非约翰内斯堡夏洛特·马克斯凯学术医院的病毒学诊所，招募了接受司他夫定治疗至少 6 个月的 HIV 阳性南非黑人（n=395），并使用艾滋病临床试验组神经病变筛查工具筛查神经病。如果患者既有周围神经病的症状又有体征，则将 HIV-SN 定义为存在。如果存在，则记录症状的分布和强度。此外，还记录并分析了人体测量学、人口统计学和临床信息作为危险因素。
有症状的 HIV-SN 的患病率为 57%（395 例中有 226 例）。在使用司他夫定的患者中，年龄和身高的增加与 SN 的发生独立相关。疼痛是报告有 HIV-SN 的参与者的主要症状（76%，226 例中有 172 例），其次是麻木（48%，226 例中有 108 例）和刺痛（46%，226 例中有 105 例）。大约四分之三的参与者将其症状评为中度至重度强度。症状总是存在于脚部，只有 23%的参与者出现脚部近端症状。
在该人群中，HIV-SN 很常见，并且常伴有脚部中度至重度疼痛。HIV-SN 与年龄和身高的增加显著相关，这些因素可以在开司他夫定之前以不增加成本的方式进行测量，从而使高风险患者优先获得非神经毒性药物。
