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SCREENING FOR HIV‐ASSOCIATED DISTAL‐SYMMETRIC POLYNEUROPATHY IN CDC‐CLASSIFICATION STAGES 1, 2 AND 3
Author(s) -
Husstedt Iw,
Evers S,
Reichelt D,
Grotemeyer Kh,
KammerSuhr B,
Bockenholt S,
Heese C.
Publication year - 2000
Publication title -
journal of the peripheral nervous system
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1
H-Index - 67
eISSN - 1529-8027
pISSN - 1085-9489
DOI - 10.1111/j.1529-8027.2000.022-5.x
Subject(s) - polyneuropathy , medicine , chronic inflammatory demyelinating polyneuropathy , sural nerve , outpatient clinic , neurology , human immunodeficiency virus (hiv) , pathogenesis , pathology , immunology , antibody , psychiatry
OBJECTIVES—A total of 670 patients were screened for distal symmetric HIV‐associated polyneuropathy during CDC stages 1–3 and its correlation to immunological deterioration. MATERIAL AND METHODS—Clinical examinations of 670 patients admitted to the neurological outpatient clinic at the Department of Neurology, University of Munster. Neurophysiological investigations were performed on the sural and peroneal nerve for detection of axonal and myelin lesion. RESULTS—Clinical examination proved progressive clinical signs and symptoms indicating distal symmetric polyneuropathy from CDC 1 (32%) to CDC 3 (55%). At least one neurophysiological result was impaired in CDC 1 in 25% and in CDC 3 in 45%. Significant correlation between neurophysiological changes and CDC 4(+)‐cells and beta‐microglobuline were detected for stage CDC 3 C. CONCLUSION—Results show stage related prevalence of distal symmetric polyneuropathy already in early stages. In late stages of HIV‐infection prevalence of distal symmetric polyneuropathy seems to be directly correlated to immunodeficiency syndrome. The pathogenesis of distal symmetric polyneuropathy during HIV‐infection is up to now incompletely understood, but results indicate a clear dependency between progressive immunological dysfunction and neuropathy. High active antiretroviral therapy in patients suffering from distal symmetric polyneuropathy is a main topic of future studies.