Neurology Research Group, Department of Medicine, University of Cape Town, South Africa.
Department of Statistical Sciences, University of Cape Town, South Africa.
Muscle Nerve. 2018 Mar;57(3):371-379. doi: 10.1002/mus.25710. Epub 2017 Jul 6.
We studied the evolution of sensory neuropathy after antiretroviral therapy (ART) in human immunodeficiency virus-infected South Africans.
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.
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).
Painful symptoms improved during ART. Evolving sensory neuropathy was due to increasing small and large fiber dysfunction. Muscle Nerve 57: 371-379, 2018.
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。
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。
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）。
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。
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