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Measures of small-fiber neuropathy in HIV infection

Authors
Journal
Autonomic Neuroscience
1566-0702
Publisher
Elsevier
Publication Date
Volume
169
Issue
1
Identifiers
DOI: 10.1016/j.autneu.2012.04.001
Keywords
  • Hiv
  • Qsart
  • Uens
  • Neuropathy
  • Antiretroviral
Disciplines
  • Medicine

Abstract

Abstract Introduction Noninvasive methods are needed to detect distal sensory polyneuropathy in HIV-infected persons on antiretroviral therapy (ART). Methods Quantitative sudomotor axon reflex test (QSART) and Utah Early Neuropathy Scale (UENS), small-fiber sensitive measures, were assessed in subjects with and without clinical neuropathy. Pain was assessed by visual analog scale (VAS). Results Twenty-two subjects had symptoms and signs of neuropathy, 19 had neither, and all were receiving ART. Median sweat volume (μL) was lower at all testing sites in those with neuropathy compared to those without (p<0.01 for all). UENS and VAS (mm) were higher in neuropathy subjects (p<0.05 for each). Lower sweat volume at all sites correlated with higher pin UENS subscore, total UENS, and VAS (p<0.05 for all). In multivariable analyses adjusting for age, CD4+ T cells, sex, and use of “d-drug” ART, QSART and UENS remained associated (p=0.003). Conclusion QSART and UENS have not been previously studied in this patient population and may identify small-fiber neuropathy in HIV-infected, ART-treated persons.

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