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Predictors of worsening neuropathy and neuropathic pain after 12 years in people with HIV
OBJECTIVE: Distal sensory polyneuropathy (DSP) and neuropathic pain are important clinical concerns in virally suppressed people with HIV. We determined how these conditions evolved, what factors influenced their evolution, and their clinical impact. METHODS: Ambulatory, community‐dwelling HIV serop...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359117/ https://www.ncbi.nlm.nih.gov/pubmed/32619341 http://dx.doi.org/10.1002/acn3.51097 |
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author | Ellis, Ronald J. Diaz, Monica Sacktor, Ned Marra, Christina Collier, Ann C. Clifford, David B. Calcutt, Nigel Fields, Jerel A. Heaton, Robert K. Letendre, Scott L. |
author_facet | Ellis, Ronald J. Diaz, Monica Sacktor, Ned Marra, Christina Collier, Ann C. Clifford, David B. Calcutt, Nigel Fields, Jerel A. Heaton, Robert K. Letendre, Scott L. |
author_sort | Ellis, Ronald J. |
collection | PubMed |
description | OBJECTIVE: Distal sensory polyneuropathy (DSP) and neuropathic pain are important clinical concerns in virally suppressed people with HIV. We determined how these conditions evolved, what factors influenced their evolution, and their clinical impact. METHODS: Ambulatory, community‐dwelling HIV seropositive individuals were recruited at six research centers. Clinical evaluations at baseline and 12 years later determined neuropathy signs and distal neuropathic pain (DNP). Additional assessments measured activities of daily living and quality of life (QOL). Factors potentially associated with DSP and DNP progression included disease severity, treatment, demographics, and co‐morbidities. Adjusted odds ratios were calculated for follow‐up neuropathy outcomes. RESULTS: Of 254 participants, 21.3% were women, 57.5% were non‐white. Mean baseline age was 43.5 years. Polyneuropathy prevalence increased from 25.7% to 43.7%. Of 173 participants initially pain‐free, 42 (24.3%) had incident neuropathic pain. Baseline risk factors for incident pain included unemployment (OR [95% CI], 5.86 [1.97, 17.4]) and higher baseline body mass index (BMI) (1.78 [1.03, 3.19] per 10‐units). Participants with neuropathic pain at follow‐up had significantly worse QOL and greater dependence in activities of daily living than those who remained pain‐free. INTERPRETATION: HIV DSP and neuropathic pain increased in prevalence and severity over 12 years despite high rates of viral suppression. The high burden of neuropathy included disability and poor life quality. However, substantial numbers remained pain‐free despite clear evidence of neuropathy on exam. Protective factors included being employed and having a lower BMI. Implications for clinical practice include promotion of lifestyle changes affecting reversible risk factors. |
format | Online Article Text |
id | pubmed-7359117 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-73591172020-07-17 Predictors of worsening neuropathy and neuropathic pain after 12 years in people with HIV Ellis, Ronald J. Diaz, Monica Sacktor, Ned Marra, Christina Collier, Ann C. Clifford, David B. Calcutt, Nigel Fields, Jerel A. Heaton, Robert K. Letendre, Scott L. Ann Clin Transl Neurol Research Articles OBJECTIVE: Distal sensory polyneuropathy (DSP) and neuropathic pain are important clinical concerns in virally suppressed people with HIV. We determined how these conditions evolved, what factors influenced their evolution, and their clinical impact. METHODS: Ambulatory, community‐dwelling HIV seropositive individuals were recruited at six research centers. Clinical evaluations at baseline and 12 years later determined neuropathy signs and distal neuropathic pain (DNP). Additional assessments measured activities of daily living and quality of life (QOL). Factors potentially associated with DSP and DNP progression included disease severity, treatment, demographics, and co‐morbidities. Adjusted odds ratios were calculated for follow‐up neuropathy outcomes. RESULTS: Of 254 participants, 21.3% were women, 57.5% were non‐white. Mean baseline age was 43.5 years. Polyneuropathy prevalence increased from 25.7% to 43.7%. Of 173 participants initially pain‐free, 42 (24.3%) had incident neuropathic pain. Baseline risk factors for incident pain included unemployment (OR [95% CI], 5.86 [1.97, 17.4]) and higher baseline body mass index (BMI) (1.78 [1.03, 3.19] per 10‐units). Participants with neuropathic pain at follow‐up had significantly worse QOL and greater dependence in activities of daily living than those who remained pain‐free. INTERPRETATION: HIV DSP and neuropathic pain increased in prevalence and severity over 12 years despite high rates of viral suppression. The high burden of neuropathy included disability and poor life quality. However, substantial numbers remained pain‐free despite clear evidence of neuropathy on exam. Protective factors included being employed and having a lower BMI. Implications for clinical practice include promotion of lifestyle changes affecting reversible risk factors. John Wiley and Sons Inc. 2020-07-03 /pmc/articles/PMC7359117/ /pubmed/32619341 http://dx.doi.org/10.1002/acn3.51097 Text en © 2020 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Research Articles Ellis, Ronald J. Diaz, Monica Sacktor, Ned Marra, Christina Collier, Ann C. Clifford, David B. Calcutt, Nigel Fields, Jerel A. Heaton, Robert K. Letendre, Scott L. Predictors of worsening neuropathy and neuropathic pain after 12 years in people with HIV |
title | Predictors of worsening neuropathy and neuropathic pain after 12 years in people with HIV |
title_full | Predictors of worsening neuropathy and neuropathic pain after 12 years in people with HIV |
title_fullStr | Predictors of worsening neuropathy and neuropathic pain after 12 years in people with HIV |
title_full_unstemmed | Predictors of worsening neuropathy and neuropathic pain after 12 years in people with HIV |
title_short | Predictors of worsening neuropathy and neuropathic pain after 12 years in people with HIV |
title_sort | predictors of worsening neuropathy and neuropathic pain after 12 years in people with hiv |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359117/ https://www.ncbi.nlm.nih.gov/pubmed/32619341 http://dx.doi.org/10.1002/acn3.51097 |
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