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Muscle Nerve. 2013 Oct;48(4):516-24. doi: 10.1002/mus.23795. Epub 2013 Aug 27.

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

Author information

1
Department of Neurology, University of California San Francisco, 1001 Potrero Avenue, 4M62, Box 0870, San Francisco, California, 94110, USA.

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.

KEYWORDS:

HIV; developing countries; peripheral nervous system diseases; screening tools; sensitivity and specificity

PMID:
24037693
PMCID:
PMC4019398
DOI:
10.1002/mus.23795
[Indexed for MEDLINE]
Free PMC Article
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