TY - JOUR
T1 - Early detection of peripheral neuropathy using stimulated skin wrinkling test in human immunodeficiency virus infected patients A cross-sectional study
AU - Mawuntu, Arthur H.P.
AU - Mahama, Corry N.
AU - Khosama, Herlyani
AU - Estiasari, Riwanti
AU - Imran, Darma
N1 - Publisher Copyright:
Copyright © 2018 the Author(s).
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Peripheral neuropathy is a common condition of human immunodeficiency virus (HIV)-infected patients, which often remains undetected. We assessed the performance of stimulated skin wrinkling-eutectic mixture of local anesthetic (SSW-EMLA) test compared with brief peripheral neuropathy screening (BPNS) to detect HIV neuropathy. This is a cross-sectional study conducted in HIV-positive patients. A modified skin wrinkling grading was used to assess SSW-EMLA effect. BPNS-detectable neuropathy was assessed by a combination of neuropathy severity scoring scale (subjective) and objective method of sensory and tendon reflex examination. The SSW-EMLA test accuracy with reference to BPNS was assessed using sensitivity and specificity and predictive values. In a total of 99 HIV patients, 61.6% were males and the majority age group were between 30 and 40 years (52%). The neuropathy detection was SSW-EMLA test 36.4% versus BPNS 15.2% (P = .04). The sensitivity of SSW-EMLA test was 60.0% [95% confidence interval (95% CI) 34.5–81.7], specificity 67% (95% CI 63.3–3–71.7), and overall accuracy of 66.7% (95% CI 58.9–73.2). The SSW-EMLA test detected many more peripheral neuropathy cases than BPNS in HIV patients and has potential as an alternative test for screening for HIV neuropathy in resource-constraint hospitals in Indonesia.
AB - Peripheral neuropathy is a common condition of human immunodeficiency virus (HIV)-infected patients, which often remains undetected. We assessed the performance of stimulated skin wrinkling-eutectic mixture of local anesthetic (SSW-EMLA) test compared with brief peripheral neuropathy screening (BPNS) to detect HIV neuropathy. This is a cross-sectional study conducted in HIV-positive patients. A modified skin wrinkling grading was used to assess SSW-EMLA effect. BPNS-detectable neuropathy was assessed by a combination of neuropathy severity scoring scale (subjective) and objective method of sensory and tendon reflex examination. The SSW-EMLA test accuracy with reference to BPNS was assessed using sensitivity and specificity and predictive values. In a total of 99 HIV patients, 61.6% were males and the majority age group were between 30 and 40 years (52%). The neuropathy detection was SSW-EMLA test 36.4% versus BPNS 15.2% (P = .04). The sensitivity of SSW-EMLA test was 60.0% [95% confidence interval (95% CI) 34.5–81.7], specificity 67% (95% CI 63.3–3–71.7), and overall accuracy of 66.7% (95% CI 58.9–73.2). The SSW-EMLA test detected many more peripheral neuropathy cases than BPNS in HIV patients and has potential as an alternative test for screening for HIV neuropathy in resource-constraint hospitals in Indonesia.
KW - Brief peripheral neuropathy screening
KW - Eutectic mixture of local anesthetic
KW - HIV peripheral neuropathy
KW - Indonesia
KW - Stimulated skin wrinkling test
UR - http://www.scopus.com/inward/record.url?scp=85050743815&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000011526
DO - 10.1097/MD.0000000000011526
M3 - Article
C2 - 30045275
AN - SCOPUS:85050743815
SN - 0025-7974
VL - 97
JO - Medicine (United States)
JF - Medicine (United States)
IS - 30
M1 - e11526
ER -