Sensory testing in human immunodeficiency virus type 1-infected men. HIV Neurobehavioral Research Center Group
S. J. Gulevich, J. A. Kalmijn, L. J. Thal, V. Iragui-Madoz, J. A. McCutchan, C. Kennedy and I. Grant
Department of Neurosciences, University of California, San Diego School of Medicine.
Patients with acquired immunodeficiency syndrome frequently suffer
peripheral neuropathy. We investigated its prevalence and relationship to
clinical stage of human immunodeficiency virus (HIV) infection using
quantitative sensory testing and nerve conduction testing. Vibratory
threshold was determined in the right great toe and index finger of 179 men
seropositive for HIV (28 with acquired immunodeficiency syndrome [AIDS] or
AIDS-related complex [ARC], 151 asymptomatic) and 32 HIV-seronegative
controls. None had clinical peripheral neuropathy. Abnormal threshold was
control mean plus 2.5 SDs. In the toe, 10 (36%) of 28 subjects with AIDS or
ARC had abnormal vibratory thresholds, compared with seven (5%) of 151
asymptomatic seropositive subjects and none of 32 controls. A subgroup of
168 seropositive subjects underwent nerve conduction testing. Abnormality
rates were similar, but abnormalities of nerve conduction coincided with
quantitative sensory testing abnormalities in only half the cases. Mean
(+/-SD) vibratory threshold was significantly greater in subjects with AIDS
or ARC (3.00 +/- 0.51 vibratory units) than in asymptomatic subjects (1.56
+/- 0.27 vibratory units) and controls (1.63 +/- 0.54 vibratory units).
Finger abnormality rates did not differ, although subjects with AIDS or ARC
had greater mean vibratory threshold. Subclinical peripheral neuropathy is
thus related to stage of HIV infection and is present by quantitative
sensory testing in 36% of patients with AIDS or ARC.
