High prevalence of distal sensory polyneuropathy in antiretroviral-treated and untreated people with HIV in Tanzania.


Mullin, S; Temu, A; Kalluvya, S; Grant, A; Manji, H; (2011) High prevalence of distal sensory polyneuropathy in antiretroviral-treated and untreated people with HIV in Tanzania. Tropical medicine & international health, 16 (10). pp. 1291-1296. ISSN 1360-2276 DOI: https://doi.org/10.1111/j.1365-3156.2011.02825.x

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Abstract

: Objectives? To describe the prevalence of distal sensory polyneuropathy (DSP), a complication of both advanced HIV disease and of antiretroviral therapy (ART), amongst Tanzanians with HIV, on and off ART (including stavudine) with CD4 counts above and below 200?cells/?l. Methods? We recruited participants attending ART clinic into four groups: >6?months ART exposure and (i) CD4?<?200?cells/?l or (ii) CD4?>?200?cells/?l (ART/CD4?<?200 and ART/CD4?>?200, respectively); ART-na�ve and (iii) CD4?<?200?cells/?l or iv)CD4?>?200?cells/?l (noART/CD4?<?200 and noART/CD4?>?200, respectively). Primary outcome was DSP, as defined by presence of at least one symptom and one sign. Results? Of 326 evaluable participants, 81 (32 men, median age 38?years, median CD4 142?cells/?l) were enrolled in the ART/CD4?<?200 group, 78 (17 men, median age 37?years, median CD4 345?cells/?l) in ART/CD4?>?200, 81 (30 men, median age 37?years, median CD4 128?cells/?l) in noART/CD4?<?200 and 86 (22 men, median age 33?years, median CD4 446?cells/?l) in noART/CD4?>?200. Numbness was the most commonly reported symptom. DSP prevalence ranged from 43.2% in ART/CD4?<?200 to 20.9% in noART/CD4?>?200. DSP was more common among men (adjusted odds ratio [aOR] 1.9, 95% confidence interval [CI] 1.2-3.3) and older participants (aOR 2.7, 95% CI 1.1-6.2 for age 40?+?vs. <30?years). Conclusion? Distal sensory polyneuropathy is common amongst those attending this clinic, even those with no ART exposure and a CD4 count above 200?cells/?l. Stavudine and didanosine expose HIV-infected patients to an additional avoidable risk of DSP. Access to non-neurotoxic ART regimes as well as earlier HIV diagnosis and initiation of ART is needed.<br/>

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 21707880
Web of Science ID: 295052000012
URI: http://researchonline.lshtm.ac.uk/id/eprint/438

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