Peripheral Neuropathy (N=150) (OPTION PERIOD)
The original CHARTER peripheral neuropathy aims focused on ascertaining the short-term neurotoxic impact of so-called “d-drugs” (dideoxynucleoside HIV reverse transcriptase inhibitors; ddC, ddI, d4T) on distal sensory polyneuropathy (DSPN). Our CHARTER experience to date has motivated a revision of this focus to emphasize the influence on neuropathy of long term antiretroviral drug exposure and genetic risk factors. To improve earlier ascertainment and longitudinal monitoring of nerve injury we propose to add intraepidermal nerve fiber (IENF) layer assessments (skin biopsies). The IENF technique, developed and validated over the past 5 to 10 years, provides a more direct measure of cutaneous innervation than clinical examinations or electrophysiological testing. Simple, superficial skin biopsies will be repeated over time to assess factors associated with both deterioration and improvement in peripheral nerve function.
| Cross-sectional | 1st Longitudinal | |
| Age | 43.6 (9.3) | 44.5 (9.3) |
| Education | 12.8 (2.4) | 12.8 (2.3) |
| Gender (% male) | 81% | 82% |
| Caucasian | 44% | 43% |
| Hispanic | 13% | 14% |
| African American | 41% | 41% |
| Other | 2% | 2% |
| % AIDS | 63% | 68% |
| CD4 | 427 (309 - 636) | 461 (306 - 636) |
| Log 10 Plasma HIV RNA | 2.20 (1.70 - 4.03) | 1.70 (1.70 - 3.84) |
| Log10 CSF HIV RNA | 1.70 (1.70 - 2.32) | 1.70 (1.70 - 1.99) |
| NP Impairment (% impaired) | 49% | 41% |
