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Evolution of sensory neuropathy after initiation of antiretroviral therapy

Introduction: We studied the evolution of sensory neuropathy after antiretroviral therapy (ART) in human immunodeficiency virus–infected South Africans. Methods: Enrolment commenced before ART with 6-monthly follow-ups for 24 months. Symptomatic distal sensory polyneuropathy (SDSP) was defined as on...

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Main Author: Centner, Chad
Other Authors: Heckmann, Jeannine M
Format: Thesis
Language:English
Published: Division of Medical Microbiology 2019
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access_status_str Open Access
author Centner, Chad
author2 Heckmann, Jeannine M
author_browse Centner, Chad
Heckmann, Jeannine M
author_facet Heckmann, Jeannine M
Centner, Chad
author_sort Centner, Chad
collection Thesis
description Introduction: We studied the evolution of sensory neuropathy after antiretroviral therapy (ART) in human immunodeficiency virus–infected South Africans. Methods: Enrolment commenced before ART with 6-monthly follow-ups for 24 months. Symptomatic distal sensory polyneuropathy (SDSP) was defined as one symptom and sign. Symptom/sign scores were compared between visits. Results: We enrolled 184 participants. Pre-ART, 16% had SDSP. After 18 months of ART, pain prevalence decreased in those with pre-ART SDSP (odds ratio [OR], 0.09; 95% confidence interval [95%CI], 0.03-0.29). Symptoms improved in 50% ever experiencing pain (mean improvement=-4.5 on 11-point scale). Participants SDSP-free pre-ART developed SDSP at a rate of 18 per 100 person-years. After 24 months, 18% had SDSP. Stavudine (60% of cohort) did not predict incident SDSP, but associated with increased prevalence of reduced/absent reflexes at 18 months (OR, 2.24; 95% CI, 1.08-4.65). Conclusions: Painful symptoms improved during ART. Evolving sensory neuropathy was due to increasing small and large fiber dysfunction.
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2019
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spelling oai:open.uct.ac.za:11427/29605 Evolution of sensory neuropathy after initiation of antiretroviral therapy Centner, Chad Heckmann, Jeannine M Medical Microbiology Introduction: We studied the evolution of sensory neuropathy after antiretroviral therapy (ART) in human immunodeficiency virus–infected South Africans. Methods: Enrolment commenced before ART with 6-monthly follow-ups for 24 months. Symptomatic distal sensory polyneuropathy (SDSP) was defined as one symptom and sign. Symptom/sign scores were compared between visits. Results: We enrolled 184 participants. Pre-ART, 16% had SDSP. After 18 months of ART, pain prevalence decreased in those with pre-ART SDSP (odds ratio [OR], 0.09; 95% confidence interval [95%CI], 0.03-0.29). Symptoms improved in 50% ever experiencing pain (mean improvement=-4.5 on 11-point scale). Participants SDSP-free pre-ART developed SDSP at a rate of 18 per 100 person-years. After 24 months, 18% had SDSP. Stavudine (60% of cohort) did not predict incident SDSP, but associated with increased prevalence of reduced/absent reflexes at 18 months (OR, 2.24; 95% CI, 1.08-4.65). Conclusions: Painful symptoms improved during ART. Evolving sensory neuropathy was due to increasing small and large fiber dysfunction. 2019-02-18T10:39:50Z 2019-02-18T10:39:50Z 2018 2019-02-18T08:36:41Z Master Thesis Masters MMed http://hdl.handle.net/11427/29605 eng application/pdf Division of Medical Microbiology Faculty of Health Sciences University of Cape Town
spellingShingle Medical Microbiology
Centner, Chad
Evolution of sensory neuropathy after initiation of antiretroviral therapy
thesis_degree_str Master's
title Evolution of sensory neuropathy after initiation of antiretroviral therapy
title_full Evolution of sensory neuropathy after initiation of antiretroviral therapy
title_fullStr Evolution of sensory neuropathy after initiation of antiretroviral therapy
title_full_unstemmed Evolution of sensory neuropathy after initiation of antiretroviral therapy
title_short Evolution of sensory neuropathy after initiation of antiretroviral therapy
title_sort evolution of sensory neuropathy after initiation of antiretroviral therapy
topic Medical Microbiology
url http://hdl.handle.net/11427/29605
work_keys_str_mv AT centnerchad evolutionofsensoryneuropathyafterinitiationofantiretroviraltherapy