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February 1993

Peripheral Nervous System Involvement in a Large Cohort of Human Immunodeficiency Virus—Infected Individuals

Author Affiliations

From the Department of Neurology, Division of Medicine, Wilford Hall US Air Force Medical Center, Lackland Air Force Base, Tex. The views expressed herein are those of the authors and do not necessarily reflect the views of the US Air Force or the Department of Defense.

Arch Neurol. 1993;50(2):167-171. doi:10.1001/archneur.1993.00540020045016

• 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 817 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 0.30×109/L (300 cells/mm3. Of the 300 HIV-infected volunteers without clinical 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 (<0.20×109/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.

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