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Correlates of epidermal nerve fiber densities in HIV-associated distal sensory polyneuropathy.
Neurology. 2007 Jun 12; 68(24):2113-9.Neur

Abstract

OBJECTIVE

To demonstrate the relationship between epidermal nerve fiber density (ENFD) in the leg and the phenotype of HIV-associated distal sensory polyneuropathy (HIV-DSP) in a multicenter prospective study (ACTG A5117).

METHODS

A total of 101 HIV-infected adults, with CD4 cell count <300 cells/mm(3) and who had received antiretroviral therapy (ART) for at least 15 consecutive weeks, underwent standardized clinical and electrophysiologic assessment. All 101 subjects were biopsied at the distal leg (DL) and 99 at the proximal thigh (PT) at baseline. ENFD was assessed by skin biopsy using PGP9.5 immunostaining. Associations of ENFD with demographics, ART treatment, Total Neuropathy Score (TNS), sural sensory nerve action potential (SNAP) amplitude and conduction velocity, quantitative sensory testing (QST) measures, and neuropathic pain were explored.

RESULTS

ENFD at the DL site correlated with neuropathy severity as gauged by TNS (p < 0.01), the level of neuropathic pain quantified by the Gracely Pain Scale (GPS) (p = 0.01) and Visual Analogue Scale (VAS) (p = 0.01), sural SNAP amplitude (p < 0.01), and toe cooling (p < 0.01) and vibration (p = 0.02) detection thresholds. ENFD did not correlate with neurotoxic ART exposure, CD4 cell count, or plasma HIV-1 viral load.

CONCLUSIONS

In subjects with advanced HIV-1 infection, epidermal nerve fiber density (ENFD) assessment correlates with the clinical and electrophysiologic severity of distal sensory polyneuropathy (DSP). ENFD did not correlate with previously established risk factors for HIV-DSP, including CD4 cell count, plasma HIV-1 viral load, and neurotoxic antiretroviral therapy exposure.

Authors+Show Affiliations

Department of Neurology, Johns Hopkins University, Baltimore, MD 21287-7609, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17562831

Citation

Zhou, L, et al. "Correlates of Epidermal Nerve Fiber Densities in HIV-associated Distal Sensory Polyneuropathy." Neurology, vol. 68, no. 24, 2007, pp. 2113-9.
Zhou L, Kitch DW, Evans SR, et al. Correlates of epidermal nerve fiber densities in HIV-associated distal sensory polyneuropathy. Neurology. 2007;68(24):2113-9.
Zhou, L., Kitch, D. W., Evans, S. R., Hauer, P., Raman, S., Ebenezer, G. J., Gerschenson, M., Marra, C. M., Valcour, V., Diaz-Arrastia, R., Goodkin, K., Millar, L., Shriver, S., Asmuth, D. M., Clifford, D. B., Simpson, D. M., & McArthur, J. C. (2007). Correlates of epidermal nerve fiber densities in HIV-associated distal sensory polyneuropathy. Neurology, 68(24), 2113-9.
Zhou L, et al. Correlates of Epidermal Nerve Fiber Densities in HIV-associated Distal Sensory Polyneuropathy. Neurology. 2007 Jun 12;68(24):2113-9. PubMed PMID: 17562831.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlates of epidermal nerve fiber densities in HIV-associated distal sensory polyneuropathy. AU - Zhou,L, AU - Kitch,D W, AU - Evans,S R, AU - Hauer,P, AU - Raman,S, AU - Ebenezer,G J, AU - Gerschenson,M, AU - Marra,C M, AU - Valcour,V, AU - Diaz-Arrastia,R, AU - Goodkin,K, AU - Millar,L, AU - Shriver,S, AU - Asmuth,D M, AU - Clifford,D B, AU - Simpson,D M, AU - McArthur,J C, AU - ,, PY - 2007/6/15/pubmed PY - 2007/7/13/medline PY - 2007/6/15/entrez SP - 2113 EP - 9 JF - Neurology JO - Neurology VL - 68 IS - 24 N2 - OBJECTIVE: To demonstrate the relationship between epidermal nerve fiber density (ENFD) in the leg and the phenotype of HIV-associated distal sensory polyneuropathy (HIV-DSP) in a multicenter prospective study (ACTG A5117). METHODS: A total of 101 HIV-infected adults, with CD4 cell count <300 cells/mm(3) and who had received antiretroviral therapy (ART) for at least 15 consecutive weeks, underwent standardized clinical and electrophysiologic assessment. All 101 subjects were biopsied at the distal leg (DL) and 99 at the proximal thigh (PT) at baseline. ENFD was assessed by skin biopsy using PGP9.5 immunostaining. Associations of ENFD with demographics, ART treatment, Total Neuropathy Score (TNS), sural sensory nerve action potential (SNAP) amplitude and conduction velocity, quantitative sensory testing (QST) measures, and neuropathic pain were explored. RESULTS: ENFD at the DL site correlated with neuropathy severity as gauged by TNS (p < 0.01), the level of neuropathic pain quantified by the Gracely Pain Scale (GPS) (p = 0.01) and Visual Analogue Scale (VAS) (p = 0.01), sural SNAP amplitude (p < 0.01), and toe cooling (p < 0.01) and vibration (p = 0.02) detection thresholds. ENFD did not correlate with neurotoxic ART exposure, CD4 cell count, or plasma HIV-1 viral load. CONCLUSIONS: In subjects with advanced HIV-1 infection, epidermal nerve fiber density (ENFD) assessment correlates with the clinical and electrophysiologic severity of distal sensory polyneuropathy (DSP). ENFD did not correlate with previously established risk factors for HIV-DSP, including CD4 cell count, plasma HIV-1 viral load, and neurotoxic antiretroviral therapy exposure. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/17562831/Correlates_of_epidermal_nerve_fiber_densities_in_HIV_associated_distal_sensory_polyneuropathy_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=17562831 DB - PRIME DP - Unbound Medicine ER -