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.
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Topics Discussed
Alert Me
Recommended articles
Dispersion of the distal compound muscle action potential as a diagnostic criterion for chronic inflammatory demyelinating polyneuropathy
PML-IRIS in patients with HIV infection
Classifications and treatment responses in chronic immune-mediated demyelinating polyneuropathy
Chronic inflammatory demyelinating polyneuropathy