抗反转录病毒治疗开始后感觉神经病的演变。
Evolution of sensory neuropathy after initiation of antiretroviral therapy.
机构信息
Neurology Research Group, Department of Medicine, University of Cape Town, South Africa.
Department of Statistical Sciences, University of Cape Town, South Africa.
出版信息
Muscle Nerve. 2018 Mar;57(3):371-379. doi: 10.1002/mus.25710. Epub 2017 Jul 6.
INTRODUCTION
We studied the evolution of sensory neuropathy after antiretroviral therapy (ART) in human immunodeficiency virus-infected South Africans.
METHODS
Enrolment commenced before ART with 6-monthly follow-ups for 24 months. Symptomatic distal sensory polyneuropathy (SDSP) was defined as one symptom and sign. Symptom/sign scores were compared between visits.
RESULTS
We enrolled 184 participants. Pre-ART, 16% had SDSP. After 18 months of ART, pain prevalence decreased in those with pre-ART SDSP (odds ratio [OR], 0.09; 95% confidence interval [95%CI], 0.03-0.29). Symptoms improved in 50% ever experiencing pain (mean improvement = 4.5 on 11-point scale). Participants SDSP-free pre-ART developed SDSP at a rate of 18 per 100 person-years. After 24 months (n = 102), 18% had SDSP. Stavudine (60% of cohort) did not predict incident SDSP, but associated with increased prevalence of reduced/absent reflexes at 18 months (OR, 2.24; 95% CI, 1.08-4.65).
DISCUSSION
Painful symptoms improved during ART. Evolving sensory neuropathy was due to increasing small and large fiber dysfunction. Muscle Nerve 57: 371-379, 2018.
简介
我们研究了人类免疫缺陷病毒（HIV）感染的南非人接受抗逆转录病毒治疗（ART）后感觉神经病的演变。
方法
在开始接受 ART 之前进行入组，每 6 个月进行一次随访，共 24 个月。症状性远端感觉性多发性神经病（SDSP）定义为一种症状和体征。比较就诊时的症状/体征评分。
结果
我们共纳入了 184 名参与者。在开始 ART 之前，16%的人患有 SDSP。在接受 18 个月的 ART 后，有预 ART SDSP 的患者疼痛发生率降低（比值比[OR]，0.09；95%置信区间[95%CI]，0.03-0.29）。曾经历过疼痛的患者中有 50%的症状得到改善（11 分制上平均改善 4.5 分）。在开始 ART 之前无 SDSP 的参与者，SDSP 的发生率为每 100 人年 18 例。在 24 个月（n=102）时，18%的人患有 SDSP。在该队列中 60%使用司他夫定的患者并未预测到 SDSP 的发生，但与 18 个月时反射减弱/缺失的患病率增加相关（OR，2.24；95%CI，1.08-4.65）。
讨论
疼痛症状在 ART 期间得到改善。感觉神经病的演变是由于小纤维和大纤维功能障碍的增加所致。肌肉神经 57：371-379，2018。
Zotero 插件