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. 2016 Sep 20:25:14.
doi: 10.11604/pamj.2016.25.14.9699. eCollection 2016.

Prevalent neuropathy in a cohort of HIV-infected Kenyan sex workers using antiretroviral drugs

Frank Ndaks Ndakala  1 , Julius Otieno Oyugi  2 , Margaret Ng'wono Oluka  3 , Joshua Kimani  4 , Alexandra Jablonka  5 , Georg Martin Norbert Behrens  5
Affiliations

Prevalent neuropathy in a cohort of HIV-infected Kenyan sex workers using antiretroviral drugs

Frank Ndaks Ndakala et al. Pan Afr Med J. .

Abstract

Introduction: Several risk factors including stavudine and age have been strongly associated with polyneuropathy. However, conflicting data exist on height as an independent risk factor in polyneuropathy. The objective of this study is to exclude height as an independent polyneuropathy risk factor in a cohort of human immunodeficiency virus (HIV)-infected Kenyan sex workers.

Methods: This was an analysis of prospectively collected data of treatment-naive subjects initiating either stavudine or tenofovir diphosphate fumarate or zidovudine-based antiretroviral therapy (ART) regimens from January 2008 to August 2012. Polyneuropathy was characterised as burning sensation, numbness, or dysesthesia. The study used arithmetic means of weight (kg) and height (cm) measured in duplicates using calibrated scales.

Results: After exclusion of duplicate data sets and un-confirmed cases of polyneuropathy, the study identified 212 patients without polyneuropathy, 14 pre-ART and 94 post-ART related polyneuropathy cases. Polyneuropathy cases were older but did not differ in demographic, clinical and laboratory parameters at baseline. There was a significant difference in first-line ART regimens with more patients on tenofovir disoproxil fumarate in the post-ART group (p=0.017).

Conclusion: Polyneuropathy is a common disorder among HIV-infected Kenyan sex workers. These data cannot support the postulated increased risk by height after matching for gender and ART duration. Though stavudine is associated with polyneuropathy, in this study many patients previously not exposed to stavudine developed polyneuropathy. This suggests the involvement of unknown risk factors such as genetic and metabolite differences in the development of polyneuropathy.

Keywords: Antiretroviral therapy; height; polyneuropathy; resource-limited settings; risk factor; sex workers; stavudine; tenofovir disoproxil fumarate.

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Conflict of interest statement

The authors declare no competing interest.

Figures

Figure 1
Figure 1
Percentage of stavudine-containing regimens during seven visits by HIV-infected Kenyan patients (PN-polyneuropathy)
Figure 2
Figure 2
Time to development of polyneuropathy in HIV-infected Kenyan patients
See this image and copyright information in PMC

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