Clinical and electrophysiologic evaluation of peripheral neuropathy in a group of HIV-infected patients in Thailand.

OBJECTIVE

To study characteristics of peripheral neuropathy in a group of Thai HIV-infected patients by clinical and electrophysiologic evaluation.

MATERIAL AND METHOD: Patients with HIV infection from HIV and neurology clinic were recruited during June and October 2005. Neurological examination and nerve conduction study were done in all patients to establish the presence and pattern of peripheral neuropathy. Clinical data were compared between the groups with and without HIV-related neuropathy.

RESULTS

Forty-eight HIV-infected patients were recruited but complete data were obtained in 34 patients. There were 11 males and 23 females with average age of 36.3 +/- 7.3 years. Among these, 17 (50.0%) patients received a diagnosis of HIV-related neuropathy. Distal symmetrical polyneuropathy (DSP) accounted for 64.7%, mononeuropathy multiplex (MM) for 17.6%, acute inflammatory demyelinating polyneuropathy (AIDP) for 11.8%, and progressive polyradiculopathy (PP) for 5.9% of cases with HIV-related neuropathy. The presence of neuropathy was not correlated with age, sex, body mass index, and duration of HIV infection. However, patients with HIV-related neuropathy had significantly lower nadir CD4 cell counts than patients without HIV-related neuropathy (p < 0.05). When taking antiretroviral therapy in to account, we did not find correlation of any drugs with the presence of DSP except for stavudine, which had shown a statistical trend.

CONCLUSION

The incidence of HIV-associated neuropathy in this group of Thai patients was higher than previous report. The most common pattern was distal symmetrical polyneuropathy, which was associated with low nadir CD4 cell counts.