2011年，贝宁帕拉库大学医院HIV感染患者的远端感觉性多发性神经病

Distal sensory polyneuropathy among HIV-infected patients at Parakou University Hospital, Benin, 2011.

作者信息

Adoukonou T A, Kouna-Ndouongo P, Kpangon A, Gnonlonfoun D, Kpacha B, Dovonou A, Houinato D

机构信息

UER neurologie, Faculté de médecine, Université de Parakou, 03BP10 Parakou, Benin.

Département de neurologie, Université des sciences de la Santé de Libreville, Gabon.

出版信息

Med Sante Trop. 2017 Jun 1;27(2):190-194. doi: 10.1684/mst.2017.0685.

DOI:10.1684/mst.2017.0685

PMID:28655682

Abstract

Distal sensory polyneuropathy (DSP) is the most frequent neurological complication among HIV patients, and its risk increases with use of highly active antiretroviral therapy (HAART). We aimed to assess the prevalence of DSP and the factors associated with it among HIV-infected outpatients treated at Parakou University Hospital. This cross-sectional study took place from April 15 to July 15, 2011, and included 262 patients. All patients underwent a neurological examination by two neurologists with training and clinical experience in these examinations and in the Brief Peripheral Neuropathy Screening (BPNS), which was the primary tool used here. Data from nutritional status (body mass index: BMI), social and demographic information, HAART status, and CD4 count were recorded. The factors associated with DSP were studied with multivariate analysis, using a logistic regression model and a significance level of 0.05. The study included 60 men (22.9 %). Patients' ages ranged from 16 to 74 years and averaged 36.8±10 years. All patients but one patient were infected by HIV type 1 only; that one was coinfected by types 1 and 2. The mean BMI was 22.5+/-4.2 kg/m. In all, 213 (81.3 %) received HAART, and the mean CD4 count was 355.0 cells/mm+/-236.1. The prevalence of DSP was 42.4 %. The factors associated with it on univariate analysis were age, marital status, HAART status, duration of HIV infection, and duration of HAART. Only advanced age (OR 1.8, 95 % CI 1.1-5.3) and HAART use (OR 2.3, 95 % CI 1.5-4.9) were associated with DSP in the multivariate analysis. The main symptoms were paresthesia (numbness:75.7%; burning: 39.6%; pins and needles sensation 32.4 %) and pain (23.4 %). Vibration perception at the toes was missing or reduced for 84.4 %. According to the sensory symptoms grade, 93.7 % of patients were classified in Grades 2 or 3. This study showed that the prevalence of DSP is high and that it is associated with age and HAART.

摘要

远端感觉性多发性神经病（DSP）是艾滋病患者中最常见的神经并发症，且随着高效抗逆转录病毒疗法（HAART）的使用，其风险会增加。我们旨在评估帕拉库大学医院接受治疗的HIV感染门诊患者中DSP的患病率及其相关因素。这项横断面研究于2011年4月15日至7月15日进行，共纳入262例患者。所有患者均由两名在这些检查及简易周围神经病筛查（BPNS，此处使用的主要工具）方面接受过培训且有临床经验的神经科医生进行神经学检查。记录了营养状况（体重指数：BMI）、社会和人口统计学信息、HAART状态及CD4细胞计数的数据。采用多因素分析，使用逻辑回归模型及0.05的显著性水平研究与DSP相关的因素。该研究纳入60名男性（22.9%）。患者年龄在16至74岁之间，平均年龄为36.8±10岁。除1例患者外，所有患者仅感染1型HIV；该例患者同时感染1型和2型。平均BMI为22.5±4.2kg/m²。共有213例（81.3%）患者接受HAART治疗，平均CD4细胞计数为355.0个/mm³±236.1个。DSP的患病率为42.4%。单因素分析中与DSP相关的因素有年龄、婚姻状况、HAART状态、HIV感染持续时间及HAART治疗持续时间。多因素分析中仅高龄（比值比1.8，95%可信区间1.1 - 5.3）及使用HAART（比值比2.3，95%可信区间1.5 - 4.9）与DSP相关。主要症状为感觉异常（麻木：75.7%；灼痛：39.6%；针刺感：32.4%）及疼痛（23.4%）。84.4%的患者脚趾振动觉缺失或减退。根据感觉症状分级，93.7%的患者被归类为2级或3级。该研究表明DSP患病率较高，且与年龄及HAART相关。