DISTAL SYMMETRIC POLINEUROPATHY IN HIV PATIENTS : SENSORY NERVE CONDUCTION STUDY AND STIMULATED SKIN WRINKLE TEST (CASE CONTROL STUDY)

Background: HIV related distal symmetric polyneuropathy is one of the most common neurological complication in HIV patients, with incidence rate of 50%. Neuropathy could be caused either by the neurotoxicity of the viral itself or drug related. Objective: To assess the clinical profile of neuropathy in HIV+ patients which involving Brief Peripheral Neuropathy Screening Tool(BPNST), Nerve Conduction Study(NCS), and Stimulated Skin Wrinkling(SSW) test. Patients and Methods / Material and Methods: This was a case control study of HIV patients treated in Ciptomangunkusumo Hospital with inclusion criteria were on non-stavudin anti retroviral therapy. Case group was 17 patients with BPNST positive;control group were 34 patients with BPNST negative. Peripheral neuropathy was assessed by BPNST, NCS of sensory peroneal and sural nerve and SSW. Results: Between groups, there was no significant difference on demographic data (age, sex, height, weight, and history of tuberculosis). Mean amplitude of peroneal in case and control group were 16.06±22.91 and 15±20.28 respectively; mean amplitude for sural were 5.32±3.10 and 9.75±5.28 ; mean conduction velocity (CV) of peroneal were 29.96±29.27 And 42.70±23.39; mean CV of sural were 51.20±15.06 and 54.83±6.53.The significant difference was found in sural sensory amplitude, with mean amplitude of sural in case group was b6μv. There were no significant relationship between positive BPNST result and SSW. There were significant difference in viral load between groups which case group had significant lower VL(mean 29.66 copies). Conclusion: There were significant difference in sural sensory amplitude and viral load between case and control groups.