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March 2017; 4 (2) ArticleOpen Access

A comparative study of CIDP in a cohort of HIV-infected and HIV-uninfected patients

Kaminie Moodley, Pierre L.A. Bill, Vinod Bhagu Patel
First published December 15, 2016, DOI: https://doi.org/10.1212/NXI.0000000000000315
Kaminie Moodley
From the Department of Neurology, University of KwaZulu-Natal, Durban, South Africa.
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Pierre L.A. Bill
From the Department of Neurology, University of KwaZulu-Natal, Durban, South Africa.
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Vinod Bhagu Patel
From the Department of Neurology, University of KwaZulu-Natal, Durban, South Africa.
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A comparative study of CIDP in a cohort of HIV-infected and HIV-uninfected patients
Kaminie Moodley, Pierre L.A. Bill, Vinod Bhagu Patel
Neurol Neuroimmunol Neuroinflamm Mar 2017, 4 (2) e315; DOI: 10.1212/NXI.0000000000000315

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Abstract

Objective: To investigate differences in clinical presentation, electrodiagnostic measures, CSF changes, and treatment outcome measures in HIV-infected and HIV-uninfected patients with chronic inflammatory demyelinating polyneuropathy (CIDP).

Methods: A retrospective analysis of medical records of all patients meeting the European Federation of Neurology diagnostic criteria for idiopathic CIDP was performed in 2 neuromuscular units in Kwa-Zulu Natal between 2003 and 2015.

Results: Eighty-four patients were included in the study; 39 were HIV-infected and 45 were HIV-uninfected. Among the HIV-infected patients, the majority were younger, were female, and had a monophasic progressive illness. Eighty-six percent (86%) were corticosteroid-responsive and 76% were in remission within 6–12 months requiring no further treatment. Among the HIV- uninfected patients, the majority were older, were male, and had a relapsing-remitting course. Twenty-seven percent (27%) were corticosteroid-responsive, 95% required combination therapy, and 33% were not in remission by 18 months on therapy.

Conclusion: This study shows that HIV-infected patients with CIDP were younger, were more often female, displayed a monophasic progressive course, were highly steroid-responsive, and went into remission within 12 months of corticosteroid initiation.

GLOSSARY

AIDP=
acute inflammatory demyelinating polyneuropathy;
ART=
antiretroviral therapy;
BMI=
body mass index;
CIDP=
chronic inflammatory demyelinating polyneuropathy;
ENFS=
European Federation of Neurologic Sciences;
IALCH=
Inkosi Albert Luthuli Central Hospital;
INCAT=
Inflammatory Neuropathy Cause and Treatment;
IQR=
interquartile range;
IRIS=
immune reconstitution inflammatory syndrome;
IVIg=
IV immunoglobulin;
KZN=
Kwa-Zulu Natal;
ODSS=
Overall Disability Sum Score;
PNS=
Peripheral Nerve Society;
T2 DM=
type 2 diabetes mellitus

Footnotes

  • Funding information and disclosures are provided at the end of the article. Go to Neurology.org/nn for full disclosure forms. The Article Processing Charge was paid by Professor Bill: Research Fund.

  • Supplemental data at Neurology.org/nn

  • Received September 9, 2016.
  • Accepted in final form October 21, 2016.
  • Copyright © 2016 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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