PERIPHERAL NERVOUS-SYSTEM INVOLVEMENT IN A LARGE COHORT OF HUMAN-IMMUNODEFICIENCY-VIRUS INFECTED INDIVIDUALS

Objective.-In individuals who were infected with the human immunodeficiency virus (HIV) we determined the prevalence of peripheral neuropathies (PNs) and explored the relationship between immunologic competence and nerve function. Design.-Cohort survey. Setting.-US Air Force medical center. Patients.-A population-based cohort of 81 7 individuals, 798 of whom were HIV-positive as identified by the US Air Force HIV screening program from 1985 to 1989. The average age was 29.2 years, and the majority were male with early-stage HIV disease. Main Outcome Measures.-Neurologists examined all subjects for symptoms and signs of PN. We grouped patients by CD4 T-lymphocyte count. We further studied 300 HIV-infected volunteers without clinical evidence of PN by nerve conduction studies. Results.-Twelve of the 798 HIV-positive subjects had symptoms or signs of PN. All patients with PN had CD4 counts of less than 0.30x10(9)/L (300 cells/mm3). Of the 300 HIV-infected volunteers without dinical evidence of PN who had nerve conduction studies performed, 296 had normal nerve conduction study parameters. Subjects in the group with the lowest CD4 count (<0.20x10(9)/L [<200 cells/mm3]) had significantly lower nerve conduction study parameters than subjects in groups with higher CD4 counts (P<.05). Conclusions.-Peripheral nervous system involvement is rare in patients with early HIV infection and is predominantly seen in immunologically compromised, HIV-infected persons.