Early detection of peripheral neuropathy using stimulated skin wrinkling test in human immunodeficiency virus infected patients: A cross-sectional study

Medicine (Baltimore). 2018 Jul;97(30):e11526. doi: 10.1097/MD.0000000000011526.

Abstract

Peripheral neuropathy is a common condition of human immunodeficiency virus (HIV)-infected patients, which often remains undetected. We assessed the performance of stimulated skin wrinkling-eutectic mixture of local anesthetic (SSW-EMLA) test compared with brief peripheral neuropathy screening (BPNS) to detect HIV neuropathy.This is a cross-sectional study conducted in HIV-positive patients. A modified skin wrinkling grading was used to assess SSW-EMLA effect. BPNS-detectable neuropathy was assessed by a combination of neuropathy severity scoring scale (subjective) and objective method of sensory and tendon reflex examination. The SSW-EMLA test accuracy with reference to BPNS was assessed using sensitivity and specificity and predictive values.In a total of 99 HIV patients, 61.6% were males and the majority age group were between 30 and 40 years (52%). The neuropathy detection was SSW-EMLA test 36.4% versus BPNS 15.2% (P = .04). The sensitivity of SSW-EMLA test was 60.0% [95% confidence interval (95% CI) 34.5-81.7], specificity 67% (95% CI 63.3-3-71.7), and overall accuracy of 66.7% (95% CI 58.9-73.2).The SSW-EMLA test detected many more peripheral neuropathy cases than BPNS in HIV patients and has potential as an alternative test for screening for HIV neuropathy in resource-constraint hospitals in Indonesia.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Anesthetics, Local / pharmacology
  • Cross-Sectional Studies
  • Early Diagnosis
  • Female
  • HIV Infections / complications*
  • HIV Infections / epidemiology
  • Humans
  • Indonesia / epidemiology
  • Male
  • Middle Aged
  • Neurologic Examination / methods*
  • Peripheral Nervous System Diseases* / diagnosis
  • Peripheral Nervous System Diseases* / etiology
  • Peripheral Nervous System Diseases* / physiopathology
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Skin Aging / pathology*
  • Skin Tests / methods*

Substances

  • Anesthetics, Local