Early detection of peripheral neuropathy using stimulated skin wrinkling test in human immunodeficiency virus infected patients: A cross-sectional study. Issue 30 (July 2018)

• Record Type: Journal Article
• Authors: Mawuntu, Arthur H.P.; Mahama, Corry N.; Khosama, Herlyani; Estiasari, Riwanti; Imran, Darma
• Other Names: Chaurasia. Akhilanand section editor.
• Is Part Of: Medicine. Volume 97:Issue 30(2018)
• Publication Date: 2018-07
• Subjects: brief peripheral neuropathy screening -- eutectic mixture of local anesthetic -- HIV peripheral neuropathy -- Indonesia. -- stimulated skin wrinkling test; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000011526
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : 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.