Ndakala Frank Ndaks, Oyugi Julius Otieno, Oluka Margaret Ng'wono, Kimani Joshua, Jablonka Alexandra, Behrens Georg Martin Norbert
University of Nairobi, Institute of Tropical and Infectious Diseases, Directorate of Research Management & Development, State Department of Science & Technology, Nairobi, Kenya; University of Nairobi, Institute of Tropical and Infectious Diseases, University of Manitoba, College of Medicine, Department of Medical Microbiology, Winnipeg, Manitoba, Canada.
University of Nairobi, Institute of Tropical and Infectious Diseases, University of Manitoba, College of Medicine, Department of Medical Microbiology, Winnipeg, Manitoba, Canada.
Pan Afr Med J. 2016 Sep 20;25:14. doi: 10.11604/pamj.2016.25.14.9699. eCollection 2016.
Several risk factors including stavudine and age have been strongly associated with polyneuropathy. However, conflicting data exist on height as an independent risk factor in polyneuropathy. The objective of this study is to exclude height as an independent polyneuropathy risk factor in a cohort of human immunodeficiency virus (HIV)-infected Kenyan sex workers.
This was an analysis of prospectively collected data of treatment-naive subjects initiating either stavudine or tenofovir diphosphate fumarate or zidovudine-based antiretroviral therapy (ART) regimens from January 2008 to August 2012. Polyneuropathy was characterised as burning sensation, numbness, or dysesthesia. The study used arithmetic means of weight (kg) and height (cm) measured in duplicates using calibrated scales.
After exclusion of duplicate data sets and un-confirmed cases of polyneuropathy, the study identified 212 patients without polyneuropathy, 14 pre-ART and 94 post-ART related polyneuropathy cases. Polyneuropathy cases were older but did not differ in demographic, clinical and laboratory parameters at baseline. There was a significant difference in first-line ART regimens with more patients on tenofovir disoproxil fumarate in the post-ART group (p=0.017).
Polyneuropathy is a common disorder among HIV-infected Kenyan sex workers. These data cannot support the postulated increased risk by height after matching for gender and ART duration. Though stavudine is associated with polyneuropathy, in this study many patients previously not exposed to stavudine developed polyneuropathy. This suggests the involvement of unknown risk factors such as genetic and metabolite differences in the development of polyneuropathy.
包括司他夫定和年龄在内的多种风险因素与多发性神经病密切相关。然而，关于身高作为多发性神经病独立风险因素的数据存在矛盾。本研究的目的是在一群感染人类免疫缺陷病毒（HIV）的肯尼亚性工作者中排除身高作为独立的多发性神经病风险因素。
这是一项对2008年1月至2012年8月开始接受司他夫定、替诺福韦二磷酸富马酸盐或基于齐多夫定的抗逆转录病毒疗法（ART）方案的初治受试者的前瞻性收集数据的分析。多发性神经病的特征为烧灼感、麻木或感觉异常。该研究使用校准秤重复测量的体重（kg）和身高（cm）的算术平均值。
在排除重复数据集和未确诊的多发性神经病病例后，该研究确定了212例无多发性神经病的患者、14例ART治疗前和94例ART治疗后相关的多发性神经病病例。多发性神经病病例年龄较大，但在基线时的人口统计学、临床和实验室参数方面无差异。一线ART方案存在显著差异，ART治疗后组中更多患者使用富马酸替诺福韦二吡呋酯（p=0.017）。
多发性神经病在感染HIV的肯尼亚性工作者中是一种常见疾病。这些数据不能支持在匹配性别和ART持续时间后身高增加风险的假设。尽管司他夫定与多发性神经病有关，但在本研究中，许多以前未接触过司他夫定的患者也发生了多发性神经病。这表明在多发性神经病的发生中存在未知风险因素，如遗传和代谢差异。
