Distal Sensory Peripheral Neuropathy in Human Immunodeficiency Virus Type 1-Positive Individuals Before and After Antiretroviral Therapy Initiation in Diverse Resource-Limited Settings.
Distal Sensory Peripheral Neuropathy in Human Immunodeficiency Virus Type 1-Positive Individuals Before and After Antiretroviral Therapy Initiation in Diverse Resource-Limited Settings.
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在各种资源有限的环境中开始抗逆转录病毒治疗之前和之后，人类免疫缺陷病毒 1 型阳性个体的远端感觉周围神经病变。
DOI：
10.1093/cid/ciz745
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Silva
中科院分区：
文献类型：
--
作者：
Vecchio,AlyssaC;Marra,ChristinaM;Schouten,Jeffrey;Jiang,Hongyu;Kumwenda,Johnstone;Supparatpinyo,Khuanchai;Hakim,James;Sacktor,Ned;Campbell,ThomasB;Tripathy,Srikanth;Kumarasamy,Nagalingeswaran;LaRosa,Alberto;Santos,Breno;Silva
背景远端感觉周围神经病变（DistalSensoryPeripheralNeuropathy，DSPN）是人类免疫缺陷病毒（humanimmunodeficiencyvirus，HIV）的一种并发症.我们估计DSPN的患病率在7个资源有限的设置（RLS）的组合抗逆转录病毒治疗（cART）-天真的人与艾滋病毒感染者（PLWH）相比，匹配的参与者不与艾滋病毒感染者和PLWH病毒抑制3 cART regiments.MethodsPLWH与CD 4+细胞计数<300细胞/mm 3进行标准化的神经系统检查和功能状态评估之前，每24周开始cART。结果在开始cART治疗前，21.3%的PLWH有DSPN，而非HIV感染者有8.5%有DSPN（n = 2400; χ2（df = 1）= 96.5;P< .00001）。PLWH合并DSPN比PLWH不合并DSPN更可能报告无法工作[χ2（df = 1）= 10.6;P= .001]和抑郁[χ2（df = 1）= 8.9;P= .003]。在接受cART治疗的病毒抑制患者中，DSPN的总体患病率下降：第48周为20.3%;第144周为15.3%;第192周为10.3%。在127例PLWH中观察到DSPN事件。纵向上，DSPN更可能发生在老年人（P<0.001）和受教育程度较低的PLWH（P= 0.03）。cART方案和DSPN之间没有显着的关联。结论虽然DSPN的患病率下降后，在PLWH启动cART，进一步的研究可以确定策略，以防止或改善残余DSPN后，启动cART在RLS。
BackgroundDistal sensory peripheral neuropathy (DSPN) is a complication of human immunodeficiency virus (HIV). We estimate DSPN prevalence in 7 resource-limited settings (RLSs) for combination antiretroviral therapy (cART)–naive people living with HIV (PLWH) compared with matched participants not living with HIV and in PLWH virally suppressed on 1 of 3 cART regimens.MethodsPLWH with a CD4+ count <300 cells/mm3underwent standardized neurological examination and functional status assessments before and every 24 weeks after starting cART. Matched individuals not living with HIV underwent the same examinations once.Associations between covariates with DSPN at entry were assessed using the χ2test, and virally suppressed PLWH were assessed using generalized estimating equations.ResultsBefore initiating cART, 21.3% of PLWH had DSPN compared with 8.5% of people not living with HIV (n = 2400; χ2(df = 1) = 96.5;P< .00001). PLWH with DSPN were more likely to report inability to work [χ2(df = 1) = 10.6;P= .001] and depression [χ2(df = 1) = 8.9;P= .003] than PLWH without DSPN. Overall prevalence of DSPN among those virally suppressed on cART decreased: 20.3%, week 48; 15.3%, week 144; and 10.3%, week 192. Incident DSPN was seen in 127 PLWH. Longitudinally, DSPN was more likely in older individuals (P< .001) and PLWH with less education (P= .03). There was no significant association between cART regimen and DSPN.ConclusionsAlthough the prevalence of DSPN decreased following cART initiation in PLWH, further research could identify strategies to prevent or ameliorate residual DSPN after initiating cART in RLSs.
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影响因子：
3.2
作者：
Galantino, Mary Lou A.;Kietrys, David M.;Condoluci, David V.
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DOI：
10.4236/wja.2017.72010
发表时间：
2017
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World Journal of AIDS
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DOI：
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The Medical clinics of North America
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发表时间：
2018
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