Peripheral Neuropathy in Virologically Suppressed People Living with HIV: Evidence from the PIVOT Trial

The aim of this study is to identify the factors associated with peripheral neuropathy and to explore neurofilament light chain (NfL) as a biomarker for peripheral neuropathy (PN) in effectively virologically suppressed adults living with HIV. All protease inhibitor monotherapy versus ongoing triple...

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Veröffentlicht in:Viruses Jg. 16; H. 1; S. 2
Hauptverfasser: Schuldt, Anna L., Bern, Henry, Hart, Melanie, Gompels, Mark, Winston, Alan, Clarke, Amanda, Chen, Fabian, Stöhr, Wolfgang, Heslegrave, Amanda, Paton, Nicholas I., Petzold, Axel, Arenas-Pinto, Alejandro
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Switzerland MDPI AG 19.12.2023
MDPI
Schlagworte:
Adult
Ankle
biomarkers
blood glucose
Blood levels
Blood pressure
CD4 antigen
CD4 lymphocyte count
Complications and side effects
Diabetes
Diagnosis
Drug resistance
Drug therapy
Fasting
Female
Glucose
HIV
HIV infection
HIV infections
HIV Infections - complications
HIV Infections - drug therapy
Human immunodeficiency virus
Humans
Male
males
Metabolic Syndrome
monotherapy
Neurotoxicity
odds ratio
Patient outcomes
people
Peripheral nerve diseases
peripheral nervous system diseases
Peripheral Nervous System Diseases - complications
Peripheral neuropathy
Plasma levels
Population
protease inhibitor
Protease Inhibitors - therapeutic use
Proteinase inhibitors
Regression analysis
risk
Risk Factors
standard deviation
Statistical analysis
therapeutics
Toxicity
Triglycerides
United Kingdom
metabolic syndrome
protease inhibitor
HIV
peripheral neuropathy
monotherapy
ISSN:1999-4915, 1999-4915
Online-Zugang:Volltext
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Zusammenfassung:The aim of this study is to identify the factors associated with peripheral neuropathy and to explore neurofilament light chain (NfL) as a biomarker for peripheral neuropathy (PN) in effectively virologically suppressed adults living with HIV. All protease inhibitor monotherapy versus ongoing triple therapy in the long-term management of HIV infection (PIVOT) trial participants with data on PN at baseline were included in the study. NfL plasma levels (pNfL) were measured in a sub-set of participants. Multivariable logistic regression was used to examine the associations of PN with potential risk factors (including age, sex, nadir CD4 cell count, history of dideoxynucleoside (d-drugs) exposure, and blood glucose levels) and NfL levels. Of the 585 participants included, 131 (22.4%) reported PN during the study period (median of 44 months). The participants were predominantly male (76.6%), White (68.2%), and virologically suppressed for a median period of 37 months (range of 20–63) before recruitment. The age at baseline was 44.3 years (standard deviation (SD) of 9.2). PN was independently associated with age (adjusted odds ratio (aOR) = 1.35, 95% CI of 1.20–1.52; additional 5 years), history of d-drugs (aOR 1.88, 95% CI of 1.12–3.16), height (aOR 1.19, 95% CI of 1.05–1.35; additional 5 cm), nadir CD4 cell count (aOR 1.10 CI of 1.00–1.20; 50 cells fewer), and metabolic syndrome (aOR 2.31, 95% CI of 1.27 4.20), but not pNfL. The excess risk for PN associated with d-drug use remains after the exposure has stopped for years, suggesting non-reversible toxicity. In people with HIV, metabolic syndrome is independently associated with PN. There was no additional value for pNfL as a screening test for peripheral neuropathy in effectively virologically suppressed adults living with HIV.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1999-4915
1999-4915
DOI:10.3390/v16010002