Substance abuse increases the risk of neuropathy in an HIV-infected cohort.

Publication Type
Journal Article
Year of Publication
Robinson-Papp, Jessica; Gelman, Benjamin B; Grant, Igor; Singer, Elyse; Gensler, Gary; Morgello, Susan; National NeuroAIDS Tissue Consortium
Muscle Nerve
Date Published
2012 Apr
Adult; Analysis of Variance; Anti-HIV Agents; Cohort Studies; Demography; Diagnostic and Statistical Manual of Mental Disorders; Female; HIV Infections; Humans; Longitudinal Studies; Male; Middle Aged; Polyneuropathies; Prospective Studies; Risk; Substance-Related Disorders

INTRODUCTION: Human immunodeficiency virus (HIV)-infected patients commonly develop distal symmetric polyneuropathy (DSP). Age, ethnicity, and toxic exposures may influence the risk. In this study we examined the association between substance use, antiretrovirals, ethnicity, and incident neuropathy in an HIV-infected cohort.

METHODS: Data were obtained from the National NeuroAIDS Tissue Consortium (NNTC), an ongoing, prospective cohort started in 1998. Cox proportional hazards models were used to examine the association of substance use, demographics, neurotoxic antiretrovirals, and laboratory parameters with incident neuropathy in 636 participants who were neuropathy-free at baseline.

RESULTS: The cumulative incidence of DSP was 41%. Substance use (P = 0.04), number of substances used (P = 0.04), and longer duration of HIV infection (P = 0.05) were associated with incident DSP, but demographic factors, use of neurotoxic antiretrovirals, and laboratory parameters were not.

CONCLUSIONS: Substance use and longer duration of HIV infection are risk factors for DSP in HIV-infected patients. Use of multiple substances may be particularly risky.