Clinical and Electrophysiologic Evaluation of Peripheral Neuropathy in a Group of HIV-Infected Patients in Thailand
Komwudh Konchalard MD*, Khwanrat Wangphonpattanasiri MD**
Affiliation : * Department of Rehabilitation Medicine, Queen Savang Vudhana Memorial Hospital ** Division of Neurology, Prasat Neurological Institute
Objective : To study characteristics of peripheral neuropathy in a group of Thai HIV-infected patients by
clinical and electrophysiologic evaluation.
Materials and Methods : 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 correla-
tion 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.
Keywords : Peripheral neuropathy, HIV infection, Electrodiagnosis, Antiretroviral drug, Nadir CD4 cell counts, Distal symmetrical polyneuropathy, Thai
