I Putu Eka WIDYADHARMA, Michaela Arshanty LIMAWAN, AAA Putri Laksmi DEWI, I made Oka ADNYANA, DPG Purwa SAMATRA, Ismail SETYOPRANOTO, AA Raka SUDEWI

Risk factors for peripheral neuropathy in HIV patients: A systematic review

Aim: Neurologic complication is the most complication of HIV infection, peripheral neuropathy, specifically with about 30-67% ofHIV patients experiencing this condition. Distal sensory peripheral neuropathies (DSP) associated with severe pain and lack of apatient’s quality of life, and it has been documented to have up to 60% in advanced HIV prevalence. Other factors such as older ages,alcohol use, anti-tuberculosis drugs, low cell count of CD4+, deficiency of some nutrition, women, and high plasma viral load areannounced as risk factors for PN in early publication.To perform a systematic review to identify risk factors estimates of peripheral neuropathy among HIV-infected adult patients.Material and Methods: We use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement andchecklist in this review. A search to review articles was performed in PubMed, MEDLINE, PROQUEST, EMBASE, and Google Scholarthat were published from January 2014 to December 2018. We approved the latest five years of publications. Study titles were firstscreened, then second selection by title and abstract reviews. For the third and last selection, we tested those full text, then appliedeligibility criteria.Results: We found 17795 citations, and at the end, four publications included. We found that age is a high-risk factor for peripheralneuropathy in HIV-patients, perhaps due to the increased risk of polyneuropathy as a consequence of oxidative stress and lessefficient peripheral nerve regeneration among older people. Female was more likely to develop PN, although only one study confirmedthis according to our analysis. Besides, PN was found higher among individuals who had previous CART use but later discontinued,thereby increasing the risk of PN. Of note, individuals with detectable viral load at entry had more probability of new DSP.Conclusion: Age, female sex, CART discontinuation, and initially, detectable viral load were at an increased risk of suffering fromperipheral neuropathy in HIV-patients.

PDF

___

1. Global Health Observatory data repository. https:// www.who.int/hiv/data/en/ access date 2017.
2. Ferrari S, Vento S, Monaco S, et al. Human immunodeficiency virus-associated peripheral neuropathies. Mayo Clin Proc 2006;81:213-9.
3. Benevides MLACSE, Filho SB, Debona R, et al. Prevalence of Peripheral Neuropathy and associated factors in HIV-infected patients. J Neurol Sci 2017;375:316-20.
4. Fuller GN, Jacobs JM, Guiloff RJ. Nature and incidence of peripheral nerve syndromes in HIV infection. J Neurol Neurosurg Psychiatry 1993;56:372-81.
5. McArthur JH. The reliability and validity of the subjective peripheral neuropathy screen. J Asso Nur in AIDS care 1998;9:84-94.
6. Simpson DM, Kitch D, Evans SR, et al. HIV neuropathy natural history cohort study: assessment measures and risk factors. Neurology 2006;66:1679-87.
7. Bacellar H, Muñoz A, Miller EN, et al. temporal trends in the incidence of HIV-1-related neurologic diseases. Neurology 1994;44:1892-900.
8. Payne BA, Wilson IJ, Hateley CA, et al. Mitochondrial aging is accelerated by anti-retroviral therapy through the clonal expansion of mtDNA mutations. Nat Genet 2011;43:806-10.
9. Evans SR, Ellis RJ, Chen H, et al. Peripheral neuropathy in HIV: Prevalence and risk factors. AIDS 2011;25:919- 28.
10. Cherry CL, Skolasky RL, Lal L, et al. Antiretroviral use and other risks for HIV-associated neuropathies in an international cohort. Neurology 2006;66:867-73.
11. Maritz J, Benatar M, Dave JA, et al. HIV neuropathy in South Africans: frequency, characteristics, and risk factors. Muscle Nerve 2010;41:599-606.
12. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6.
13. Malvar J, Vaida F, Sanders CF, et al. Predictors of new-onset distal neuropathic pain in HIV-infected individuals in the era of combination antiretroviral therapy. Pain 2015;156:731-9.
14. Ekenze OS, Nwosu CM, Ogunniyi A. Frequency and risk factors for distal sensory neuropathy in HIV infection in a developing country. Int J STD AIDS 2014;25:178- 83.
15. Kiwuwa-Muyingo S, Kikaire B, Mambule I, Musana H, Musoro G, Gilks CF, et al. Prevalence, Incidence and predictors of peripheral neuropathy in African adults with HIC infection within the DART trial. AIDS 2014;28:2579-88.
16. Tumusiime DK1, Venter F, Musenge E, et al. Prevalence of peripheral neuropathy and its associated demographic and health status characteristic, among people on antiretroviral therapy in Rwanda. BMC Public Health 2014;14:1306.
17. Mehta SA, Ahmed A, Kariuki BW, et al. Implementation of a validated peripheral neuropahy screening tool in patients receiving antiretroviral therapy in Mombasa, Kenya. Am J Trop Med Hyg 2010;83:565-70.
18. Oshinaike O, Akinbami A, Ojo O, et al. Influence of age and neurotoxic HAART use on frequency of HIV sensory neuropathy. AIDS Research and Treatment. Med-Science. Accepted article: 2012;961510:5.
19. Currier JS, Spino C, Grimes J, et al. DIfferences between women and men in adverse events and CD4+ responses to nucleoside analogue therapy for HIV infection. J Acquir Immune Defic Syndr. 2000;24:316- 24.
20. Hall HI, Frazier EL, Rhodes P, et al. Differences in human immunodeficiency virus care and treatment among subpopulations in the US. JAMA Intern Med 2013;173:1337-44.
21. Tagliati M, Grinnell J, Godbold J, et al. Peripheral nerve function in HIV infection: clinical, electrophysilogic and laboratory findings. Arch Neurol 1999;56:84-9.
22. Hambleton J. Haematologic complication of HIV infection. Oncology 1996;10:671-80.