Prevalence and Risk Factors for HIV-associated Peripheral Sensory Neuropathy in HIV-infected Adults in Daegu, Korea

Hee-Young Hwang; Hyun-Ha Chang; Shin-Woo Kim; Seong Yeol Ryu; Hye-In Kim; Ga-Young Park; Yu-Jin Kwon; Jong-Myung Lee; Nung-Soo Kim

doi:10.4068/cmj.2009.45.3.161

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Hwang, Chang, Kim, Ryu, Kim, Park, Kwon, Lee, and Kim: Prevalence and Risk Factors for HIV-associated Peripheral Sensory Neuropathy in HIV-infected Adults in Daegu, Korea

Original Article

Chonnam Medical Journal

Chonnam Medical Journal 2009; 45(3): 161-167.

Published online: 10 December 2009

DOI: https://doi.org/10.4068/cmj.2009.45.3.161

Prevalence and Risk Factors for HIV-associated Peripheral Sensory Neuropathy in HIV-infected Adults in Daegu, Korea

Hee-Young Hwang, Hyun-Ha Chang, Shin-Woo Kim, Seong Yeol Ryu¹, Hye-In Kim, Ga-Young Park, Yu-Jin Kwon, Jong-Myung Lee, Nung-Soo Kim

Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

¹Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.

Corresponding author (changhha@knu.ac.kr)

Accepted 18 September 2009

Abstract

Peripheral neuropathies complicate all stages of HIV infection and cause considerable morbidity and disability in HIV-infected individuals. The aim of this study was to describe the prevalence and risk factors of HIV-associated symptomatic distal sensory polyneuropathy (HIV-DSPN) in the HAART era in Daegu, Korea. HIV-infected adults visiting two tertiary teaching hospitals in Daegu during a 2-month period (October 2008 to November 2008) were screened for HIV-DSPN. HIV-DSPN was defined as being present if the patient had neuropathic symptoms or abnormal neurologic signs. Demographic, clinical, laboratory, and treatment data were collected, and statistical analysis was done. One hundred fifty patients (136 patients in Kyungpook National University Hospital and 14 patients in Dongsan Medical Center) were screened. The prevalence of HIV-DSPN was 16.0% (24/150). In the univariate analysis, the statistically significant risk factors for symptomatic peripheral sensory neuropathy were older age [40.6±9.4 years in the DSPN(-) group vs. 46.2±9.5 years in the DSPN(+) group, p=0.009], diagnosis of AIDS [odds ratio: 4.605 (95% CI: 1.305~16.256), p=0.011], and treatment of tuberculosis [odds ratio: 3.912 (95% CI: 1.352~11.317), p=0.015]. In the multivariate analysis, older age (odds ratio: 1.082, 95% CI: 1.024~1.143, p=0.005) and diagnosis of AIDS (odds ratio: 7.861, 95% CI: 1.330~46.452, p=0.023) were still significant risk factors. HIV-DSPN was not uncommon among ambulatory patients (16.0% prevalence) in Daegu, Korea, and more careful history taking and physical examination for HIV-DSPN should be performed in the management of older AIDS patients.

Keywords: HIV infections, AIDS, Neuropathy, Risk factors

Figures and Tables

Fig. 1

The prevalence of HIV-associated DSPN in Daegu (DSPN; distal sensory polyneuropathy, KNUH; Kyungpook Natl. Univ. Hospital, DSMC; Dongsan Medical Center).

Table 1

Baseline characteristics of 150 HIV infected patients from Kyungpook National University Hospital and Keimyung Dongsan Medical Center

DSPN, distal sensory polyneuropathy; AIDS, acquired immunodeficiency syndrome.

Table 2

Univariate analysis of the comorbid diseases and opportunistic infections for HIV-associated DSPN

C.I., confidence interval; HBV, hepatitis B virus; HCV, hepatitis C virus; CMV, cytomegalovirus.

Table 3

Univariate analysis of the treatment exposure for HIV-associated DSPN

NRTI, nucleoside reverse transcriptase inhibitor; NNRTI, non-nucleoside reverse transcriptase inhibitor; PI, protease inhibitor.

Table 4

Multivariate analysis of risk factors for HIV-associated DSPN

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