Early detection of peripheral neuropathy using stimulated skin wrinkling test in human immunodeficiency virus infected patients A cross-sectional study

Arthur H.P. Mawuntu, Corry N. Mahama, Herlyani Khosama, Riwanti Estiasari, Darma Imran

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12 Citations (Scopus)

Abstract

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.

Original languageEnglish
Article numbere11526
JournalMedicine (United States)
Volume97
Issue number30
DOIs
Publication statusPublished - 1 Jul 2018

Keywords

  • Brief peripheral neuropathy screening
  • Eutectic mixture of local anesthetic
  • HIV peripheral neuropathy
  • Indonesia
  • Stimulated skin wrinkling test

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