Screening for distal sensory peripheral neuropathy in HIV-infected persons in research and clinical settings.

Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

Screening for distal sensory peripheral neuropathy in HIV-infected persons in research and clinical settings.

Neurology. 1998 Dec;51(6):1678-81. Unique Identifier : AIDSLINE MED/99071164
Marra CM; Boutin P; Collier AC; Department of Neurology, University of Washington, Seattle, USA.

Abstract: OBJECTIVE: To determine the accuracy of a screening examination for distal sensory peripheral neuropathy (DSPN) performed by nonphysician clinicians and to explore the associations between DSPN and clinical features in HIV-infected persons. METHODS: A case-control study of a volunteer sample of 226 HIV-infected individuals was performed. An interview, focusing on risks and symptoms of DSPN, and a screening neurologic examination were performed. RESULTS: Compared with the neurologist's examinations, the clinicians' examination was sensitive (92 to 95%) but not as specific (71 to 84%) for the diagnosis of DSPN. After excluding 27 patients with confounders, 42 of 199 patients (21%) had DSPN. This was associated significantly with neurotoxic nucleoside antiretroviral use and with more advanced HIV disease. Of the 42 patients with DSPN, 30 (71%) had no neuropathy symptoms. CONCLUSIONS: A brief examination performed by trained nonphysician clinicians can be used to screen for DSPN in HIV-infected persons. Asymptomatic DSPN is common in these individuals.

Keywords: JOURNAL ARTICLE Acquired Immunodeficiency Syndrome/*COMPLICATIONS/IMMUNOLOGY Adult Female Follow-Up Studies Human Logistic Models Male Mass Screening/*STANDARDS Middle Age Neurologic Examination/STANDARDS Neurons, Afferent/PHYSIOLOGY Peripheral Nerves/CYTOLOGY/VIROLOGY Peripheral Nervous System Diseases/*DIAGNOSIS/IMMUNOLOGY/ *VIROLOGY Reproducibility of Results Support, U.S. Gov't, P.H.S.
990330
A9931041

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