DISTAL SENSORY POLYNEUROPATHY IN HIV

Imran Darma. THESIS. Faculty of Medicine, University of Indonesia, Jakarta, 2005

Objectives
To determine prevalence of distal sensory polyneuropathy (DSP) in HIV infected patients, whether clinical manifestation are affected by HIV disease stage, CD4 cell count or other clinical variables.

Methods
Seventy two of HIV patients attending Pokdisus out patient clinic at Cipto Mangunkusumo Hospital in July to September 2004 were included in this cross sectional study after excluding confounding factors. An interview focusing on risk and symptoms of DSP, neurologic examination and electroneurography study were performed. DSP was diagnosed if subjects had simptoms of peripheral neuropathy in distal limb, decreased or absent ankle jerks, decreased or absent vibratory perception at the toes and electroneurographic evidence of polyneuropathy. A p value of < 0,05 was considered significant.

Results
The 72 patients 52 were classified as AIDS and 20 as asymptomatic HIV. The majority of patients were males 62 (86.1 %). The ages of patients ranged from 21 45 years, mean 26.9 years. Risk factors for HIV were IDU in 73.6% and sexual in 26.4%. CD4 cell count ranged from 1 to 1562 sel/mm³ , median 113 sel/mm³. Clinical and electroneurographic evidence of DSP was revealed in 20.8% (15/72) of the patients. Significant association between lower CD4 count and DSP was found (p=0.002).

Conclusion
DSP was found in 20.8% of the patients. Subject with low CD4 cell count commonly have DSP.

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