PROGRESSION OF DISTAL-SYMMETRICAL POLYNEUROPATHY IN HIV-INFECTION - APROSPECTIVE-STUDY

Objective: To investigate progression of distal-symmetric sensory poly neuropathy and its correlation to immunological development. Methods: Clinical, neurophysiological and immunological parameters were followe d in 42 HIV-infected patients for 13 +/- 6 months. Neurophysiological investigations were performed in the sural and peroneal nerve. Initial ly, 14 patients showed clinical signs of polyneuropathy (paresthesia, hypesthesia, diminution of vibration and deep ankle reflexes) compared with 28 patients at the end of the follow-up, 13 +/- 6 months later. Results: All neurophysiological parameters deteriorated during the obs ervation period. In 20 patients changes of plasma immunoglobulin (Ig) G, IgM, IgA levels, T- helper-, T-suppressor-, natural killer cell cou nts and plasma beta2-microglobulin were determined. There was a signif icant correlation between the development of IgG, IgM, IgA and paired stimulation and conduction velocity of the sural nerve (Spearman's ran k-correlation coefficient, P<0.05). Conclusion: These results show tha t distal-symmetric polyneuropathy during HIV infection is rapidly prog ressive and related to immunological factors. It is assumed that immun ological mechanisms play an important part in the pathogenesis of poly neuropathy during HIV infection.