Severity of HIV-associated neuropathy is associated with plasma HIV-1 RNA levels

被引:55
作者
Simpson, DM
Haidich, AB
Schifitto, G
Yiannoutsos, CT
Geraci, AP
McArthur, JC
Katzenstein, DA
机构
[1] CUNY Mt Sinai Sch Med, Dept Neurol, New York, NY 10029 USA
[2] CUNY Mt Sinai Sch Med, Dept Clin Neurophysiol, New York, NY 10029 USA
[3] Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA
[4] Univ Rochester, Dept Neurol, Rochester, NY USA
[5] Johns Hopkins Univ, Dept Neurol, Baltimore, MD 21218 USA
[6] Johns Hopkins Univ, Dept Epidemiol, Baltimore, MD 21218 USA
[7] Stanford Univ, Dept Med, Stanford, CA 94305 USA
关键词
peripheral neuropathy; neuropathic pain; HIV; plasma viral load;
D O I
10.1097/00002030-200202150-00012
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objective: To determine if there is an association between plasma HIV-1 RNA levels and severity of HIV-associated distal symmetrical polyneuropathy (DSP). Design: Substudy of AIDS Clinical Trials Group Protocol 291, a double-blind, placebo-controlled study of recombinant human nerve growth factor for the treatment of painful DSP. Methods: Two-hundred and thirty-six subjects had plasma HIV-1 RNA load assayed at baseline, Mean and maximum neuropathic pain was assessed once daily by the Gracely Pain Scale. Other measures included subjects' global pain assessment and quantitative sensory tests (QST). These values were correlated with baseline HIV-1 RNA levels. Results: Among 168 subjects with detectable plasma HIV-1 RNA, there was a significant correlation between plasma HIV-1 RNA and the severity of maximum and global pain, and toe cooling thresholds. Maximum and global pain assessment correlated with plasma HIV-1 RNA in individuals with detectable viral load (r, 0.162 and 0.194; P = 0.04 and 0.01, respectively). Conclusions: There is an association between plasma HIV-1 RNA levels and the severity of pain and QST results in HIV-associated DSP. Further studies are needed to determine if aggressive use of antiretroviral drugs, including the use of dideoxynucleosides, may be of benefit to prevent or improve peripheral neuropathy. (C) 2002 Lippincott Williams Wilkins.
引用
收藏
页码:407 / 412
页数:6
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