Peripheral neuropathy in HIV patients in sub-Saharan Africa failing first-line therapy and the response to second-line ART in the EARNEST trial

Journal of Neurovirology
Alejandro Arenas-PintoEARNEST Trial Team

Abstract

Sensory peripheral neuropathy (PN) remains a common complication in HIV-positive patients despite effective combination anti-retroviral therapy (ART). Data on PN on second-line ART is scarce. We assessed PN using a standard tool in patients failing first-line ART and for 96 weeks following a switch to PI-based second-line ART in a large Randomised Clinical Trial in Sub-Saharan Africa. Factors associated with PN were investigated using logistic regression. Symptomatic PN (SPN) prevalence was 22% at entry (N = 1,251) and was associated (p < 0.05) with older age (OR = 1.04 per year), female gender (OR = 1.64), Tuberculosis (TB; OR = 1.86), smoking (OR = 1.60), higher plasma creatinine (OR = 1.09 per 0.1 mg/dl increase), CD4 count (OR = 0.83 per doubling) and not consuming alcohol (OR = 0.55). SPN prevalence decreased to 17% by week 96 (p = 0.0002) following similar trends in all study groups (p = 0.30). Asymptomatic PN (APN) increased over the same period from 21 to 29% (p = 0.0002). Signs suggestive of PN (regardless of symptoms) returned to baseline levels by week 96. At weeks 48 and 96, after adjusting for time-updated associations above and baseline CD4 count and viral load, SPN was strongly associated with TB (p < 0.0001). In...Continue Reading

References

Apr 16, 1999·Statistics in Medicine·S van BuurenD L Knook
Dec 23, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Kenneth A LichtensteinUNKNOWN HIV Outpatient Study Investigators
Dec 13, 2005·Journal of Neurovirology·Ronald J EllisUNKNOWN AIDS Clinical Trials Group Study Teams A5001 and A362
Dec 11, 2008·Annals of Neurology·Ronald J EllisUNKNOWN CHARTER Group
Apr 24, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Daniel J WestreichPatrick Macphail
Jul 14, 2010·AIDS Research and Human Retroviruses·Beau K NakamotoCecilia M Shikuma
Dec 15, 2010·Journal of Pain and Symptom Management·Antonia L WadleyPeter R Kamerman
Feb 19, 2011·AIDS·Scott R EvansDavid B Clifford
Apr 12, 2011·The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease·J J van der WattJ M Heckmann
Jun 15, 2011·Best Practice & Research. Clinical Endocrinology & Metabolism·Il Joon Paik, Donald P Kotler
Aug 17, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Sapna A MehtaSumathi Sivapalasingam
Mar 1, 2012·Current Pain and Headache Reports·Peter R KamermanCatherine L Cherry
Aug 1, 2012·PloS One·Joep J van OosterhoutRobert S Heyderman
May 22, 2013·PloS One·Asma ShaikhPeter R Kamerman
Dec 4, 2013·Journal of Neurovirology·Huichao ChenScott R Evans
Jul 12, 2014·The New England Journal of Medicine·Nicholas I PatonUNKNOWN EARNEST Trial Team

❮ Previous
Next ❯

Citations

Mar 23, 2017·Journal of the Neurological Sciences·Maria Luiza Areal Corrêa de Sá E BenevidesJean Costa Nunes
Jun 1, 2017·Muscle & Nerve·Chad M CentnerJeannine M Heckmann
Apr 15, 2020·Neurology·Amanda C Guidon, Anthony A Amato
Jul 26, 2018·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Dorina OnoyaMatthew P Fox
Aug 24, 2018·The South African Journal of Physiotherapy·Peter C MhariwaDouglas Maleka
Jan 30, 2019·BMC Research Notes·Nicolette Comley-WhiteVeronica Ntsiea

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antitubercular Agents

Antitubercular agents are pharmacologic agents for treatment of tuberculosis. Discover the latest research on antitubercular agents here.

Antitubercular Agents (ASM)

Antitubercular agents are pharmacologic agents for treatment of tuberculosis. Discover the latest research on antitubercular agents here.