Ekenze Oluchi S, Nwosu Cosmas M, Ogunniyi Adesola
Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria.
Int J STD AIDS. 2014 Mar;25(3):178-83. doi: 10.1177/0956462413498226. Epub 2013 Jul 29.
Distal sensory polyneuropathy is a source of morbidity in HIV infection. This study aims to determine the frequency and effect of demographic and clinical variables on distal sensory polyneuropathy, among HIV-positive participants in south-east Nigeria. The study involved highly active antiretroviral therapy (HAART)-naive, patients on HAART and HIV-negative matched controls conducted at the University of Nigeria Teaching Hospital, Enugu south-east Nigeria. Distal sensory polyneuropathy was diagnosed with clinical evaluation and the use of Bio Thesiometer, 10 g monofilament and ankle reflex. There were 100 participants in each of the groups, comprising 109 (36.3%) men and 191 (63.7%) women, with median age of 35 years. About 42.5% (85/200) of the HIV-positive participants (37 drug naive and 48 on HAART) had distal sensory polyneuropathy. None in the control group had distal sensory polyneuropathy. Age (p = 0.02), height (p = 0.002), low haemoglobin (p = 0.03) and mean duration on HAART (p = 0.006) were significantly associated with distal sensory polyneuropathy, while gender (p = 0.497), body mass index (p = 0.657) and CD4 count (p = 0.482) did not affect distal sensory polyneuropathy. Low haemoglobin, height, and duration on HAART were independent risk factors for distal sensory polyneuropathy. Addressing correctable causes of anaemia, and alternatives to neurotoxic HAART may minimize the risk of distal sensory polyneuropathy.
远端感觉性多发性神经病变是HIV感染导致发病的一个原因。本研究旨在确定在尼日利亚东南部的HIV阳性参与者中，人口统计学和临床变量对远端感觉性多发性神经病变的影响频率。该研究在尼日利亚东南部埃努古的尼日利亚大学教学医院开展，涉及未接受高效抗逆转录病毒治疗（HAART）的患者、接受HAART治疗的患者以及HIV阴性的匹配对照组。通过临床评估以及使用生物感觉阈值测定仪、10g单丝和踝反射来诊断远端感觉性多发性神经病变。每组有100名参与者，其中男性109名（36.3%），女性191名（63.7%），中位年龄为35岁。约42.5%（85/200）的HIV阳性参与者（37名未接受药物治疗，48名接受HAART治疗）患有远端感觉性多发性神经病变。对照组中无人患有远端感觉性多发性神经病变。年龄（p = 0.02）、身高（p = 0.002）、低血红蛋白（p = 0.03）以及HAART治疗的平均时长（p = 0.006）与远端感觉性多发性神经病变显著相关，而性别（p = 0.497）、体重指数（p = 0.657）和CD4细胞计数（p = 0.482）对远端感觉性多发性神经病变无影响。低血红蛋白、身高以及HAART治疗时长是远端感觉性多发性神经病变的独立危险因素。解决可纠正的贫血病因以及使用非神经毒性的HAART替代方案可能会降低远端感觉性多发性神经病变的风险。
