Screening for HIV-associated distal-symmetric polyneuropathy in CDC-classification stages 1, 2 and 3

Objectives - A total of 670 patients were screened for distal symmetric HIV -associated polyneuropathy during CDC stages 1-3 and its correlation to imm unological deterioration. Material and methods Clinical examinations of 670 patients admitted to the neurological outpatient clinic at the Department of Neurology, University of Munster. Neurophysiological investigations were performed on the sural and peroneal nerve for detection of axonal and myel in lesion. Results Clinical examination proved progressive clinical signs a nd symptoms indicating distal symmetric polyneuropathy from CDC 1 (32%) to CDC 3 (55%). At least one neurophysiological result was impaired in CDC 1 i n 25% and in CDC 3 in 45%. Significant correlation between neurophysiologic al changes and CDC4(+) -cells and beta-microglobuline were detected for sta ge CDC 3 C. Conclusion - Results show stage related prevalence of distal sy mmetric polyneuropathy already in early stages. In late stages of HIV-infec tion prevalence of distal symmetric polyneuropathy seems to be directly cor related to immunodeficiency syndrome. The pathogenesis of distal symmetric polyneuropathy during HIV-infection is up to now incompletely understood, b ut results indicate a clear dependency between progressive immunological dy sfunction and neuropathy. High active antiretroviral therapy in patients su ffering from distal symmetric polyneuropathy is a main topic of future stud ies.