Screening for distal sensory peripheral neuropathy in HIV-infected personsin research and clinical settings

Objective: To determine the accuracy of a screening examination for distal sensory peripheral neuropathy (DSPN) performed by nonphysician clinicians a nd to explore the associations between DSPN and clinical features in HIV-in fected persons. Methods: A case-control study of a volunteer sample of 226 HIV-infected individuals was performed. An interview, focusing on risks and symptoms of DSPN, and a screening neurologic examination were performed. R esults: Compared with the neurologist's examinations, the clinicians' exami nation was sensitive (92 to 95%) but not as specific (71 to 84%) for the di agnosis of DSPN. After excluding 27 patients with confounders, 42 of 199 pa tients (21%) had DSPN. This was associated significantly with neurotoxic nu cleoside antiretroviral use and with more advanced HIV disease. Of the 42 p atients with DSPN, 30 (71%) had no neuropathy symptoms. Conclusions: A brie f examination performed by trained nonphysician clinicians can be used to s creen for DSPN in HIV-infected persons. Asymptomatic DSPN is common in thes e individuals.