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Screening for HIV-associated peripheral neuropathy in resource-limited settings.

  • Author(s): Cettomai, Deanna
  • Kwasa, Judith K
  • Birbeck, Gretchen L
  • Price, Richard W
  • Cohen, Craig R
  • Bukusi, Elizabeth A
  • Kendi, Caroline
  • Meyer, Ana-Claire L
  • et al.

Published Web Location

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4019398/
No data is associated with this publication.
Abstract

Introduction

Peripheral neuropathy is the most common neurological complication of human immunodeficiency virus (HIV) infection but is widely under-diagnosed in resource-limited settings. We investigated the utility of screening tools administered by nonphysician healthcare workers (HCW) and quantitative sensory testing (QST) administered by trained individuals for identification of moderate/severe neuropathy.

Methods

We enrolled 240 HIV-infected outpatients using 2-stage cluster randomized sampling. HCWs administered the several screening tools. Trained study staff performed QST. Tools were validated against a clinical diagnosis of neuropathy.

Results

Participants were 65% women, mean age 36.4 years, median CD4 324 cells/μL. A total of 65% were taking antiretrovirals, and 18% had moderate/severe neuropathy. The screening tests were 76% sensitive in diagnosing moderate/severe neuropathy with negative predictive values of 84-92%. QST was less sensitive but more specific.

Conclusions

Screening tests administered by HCW have excellent negative predictive values and are promising tools for scale-up in resource-limited settings. QST shows promise for research use.

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