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Sensory Testing in Human Immunodeficiency Virus Type 1-Infected Men
Steven J. Gulevich, MD;
Jelger A. Kalmijn;
Leon J. Thal, MD;
Vicente Iragui-Madoz, MD, PhD;
J. Allen McCutchan, MD;
Charles Kennedy, MD;
Igor Grant, MD;
HIV Neurobehavioral Research Center Group
Arch Neurol. 1992;49(12):1281-1284.
Abstract
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• 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.
Author Affiliations
From the Departments of Neurosciences (Drs Gulevich, Thal, and Iragui-Madoz and Mr Kalmijn), Medicine (Dr McCutchan), and Psychiatry (Dr Grant), University of California at San Diego School of Medicine; Veterans' Administration Hospital, and the Navy Hospital (Dr Kennedy), San Diego. Dr Gulevich is now with the Colorado Neurological Institute, Englewood.
Footnotes
Accepted for publication June 10, 1992.
The opinions or assertions expressed herein are those of the authors and are not to be construed as official or as reflecting the views of the Navy department or the naval services at large.
Reprint requests to the Colorado Neurological Institute, 799 East Hampden Ave, Suite 500, Englewood, CO 80110 (Dr Gulevich).
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