Sensory neuropathy and metabolic risk factors in human immune deficiency virus infected South Africans receiving protease inhibitors

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dc.contributor.authorVermaak, John-Randel
dc.contributor.authorDave, Joel A
dc.contributor.authorLevitt, Naomi
dc.contributor.authorHeckmann, Jeannine M
dc.date.accessioned2021-10-08T11:06:55Z
dc.date.available2021-10-08T11:06:55Z
dc.date.issued2015
dc.description.abstractBackgroundProtease inhibitors (PI)s have been associated with distal sensory polyneuropathy (DSP) and metabolic complications in high-income countries. No data exist in Africans where second-line antiretroviral therapy (ART) often include PIs.MethodWe performed a cross-sectional study to assess the DSP frequency and metabolic risk factors in community-based South Africans taking ritonavir-boosted lopinavir as PI. Examination findings categorized subjects as having DSP (≥1 neuropathic sign) or symptomatic DSP [DSP with symptom(s)]. Fasting-state glucose and lipid profiles were assessed. We compared the ritonavir/lopinavir-group to a nested group on first-line ART [dideoxy-nucleoside reverse transcriptase inhibitors (d-drugs)] selected from a dataset collected at the same time and matched for d-drug exposure.ResultsThe ritonavir/lopinavir-group (n=86) consisted predominantly of women (84%) with a median age of 36years (IQR 32–41). The median current CD4+ count was 489cells/μL (IQR 291–665). The median exposure time to ritonavir/lopinavir was 18months (IQR 10–26) and to d-drugs, 24months (IQR 16–38). DSP was present in 78% and symptomatic DSP in 48%; symptoms were most frequently of moderate intensity. Only age independently associated with DSP and symptomatic DSP (p=0.08 and p=0.04, respectively). None of the metabolic syndrome components showed associations with DSP or symptomatic DSP despite a trend towards hypertriglyceridemia overall. The ritonavir/lopinavir-group had less DSP compared to the d-drug only group (p=0.002) but the frequency of symptomatic DSP was similar (p=0.49).ConclusionRitonavir-boosted lopinavir did not add additional risk to developing DSP in this community-based African cohort after a median of 18months on second-line ART.Electronic supplementary materialThe online version of this article (doi:10.1186/s12981-015-0073-8) contains supplementary material, which is available to authorized users.
dc.identifier.apacitationVermaak, J., Dave, J. A., Levitt, N., & Heckmann, J. M. (2015). Sensory neuropathy and metabolic risk factors in human immune deficiency virus infected South Africans receiving protease inhibitors. <i>AIDS Research and Therapy</i>, 12(1), 174 - 177. http://hdl.handle.net/11427/35120en_ZA
dc.identifier.chicagocitationVermaak, John-Randel, Joel A Dave, Naomi Levitt, and Jeannine M Heckmann "Sensory neuropathy and metabolic risk factors in human immune deficiency virus infected South Africans receiving protease inhibitors." <i>AIDS Research and Therapy</i> 12, 1. (2015): 174 - 177. http://hdl.handle.net/11427/35120en_ZA
dc.identifier.citationVermaak, J., Dave, J.A., Levitt, N. & Heckmann, J.M. 2015. Sensory neuropathy and metabolic risk factors in human immune deficiency virus infected South Africans receiving protease inhibitors. <i>AIDS Research and Therapy.</i> 12(1):174 - 177. http://hdl.handle.net/11427/35120en_ZA
dc.identifier.issn1742-6405
dc.identifier.ris TY - Journal Article AU - Vermaak, John-Randel AU - Dave, Joel A AU - Levitt, Naomi AU - Heckmann, Jeannine M AB - BackgroundProtease inhibitors (PI)s have been associated with distal sensory polyneuropathy (DSP) and metabolic complications in high-income countries. No data exist in Africans where second-line antiretroviral therapy (ART) often include PIs.MethodWe performed a cross-sectional study to assess the DSP frequency and metabolic risk factors in community-based South Africans taking ritonavir-boosted lopinavir as PI. Examination findings categorized subjects as having DSP (≥1 neuropathic sign) or symptomatic DSP [DSP with symptom(s)]. Fasting-state glucose and lipid profiles were assessed. We compared the ritonavir/lopinavir-group to a nested group on first-line ART [dideoxy-nucleoside reverse transcriptase inhibitors (d-drugs)] selected from a dataset collected at the same time and matched for d-drug exposure.ResultsThe ritonavir/lopinavir-group (n=86) consisted predominantly of women (84%) with a median age of 36years (IQR 32–41). The median current CD4+ count was 489cells/μL (IQR 291–665). The median exposure time to ritonavir/lopinavir was 18months (IQR 10–26) and to d-drugs, 24months (IQR 16–38). DSP was present in 78% and symptomatic DSP in 48%; symptoms were most frequently of moderate intensity. Only age independently associated with DSP and symptomatic DSP (p=0.08 and p=0.04, respectively). None of the metabolic syndrome components showed associations with DSP or symptomatic DSP despite a trend towards hypertriglyceridemia overall. The ritonavir/lopinavir-group had less DSP compared to the d-drug only group (p=0.002) but the frequency of symptomatic DSP was similar (p=0.49).ConclusionRitonavir-boosted lopinavir did not add additional risk to developing DSP in this community-based African cohort after a median of 18months on second-line ART.Electronic supplementary materialThe online version of this article (doi:10.1186/s12981-015-0073-8) contains supplementary material, which is available to authorized users. DA - 2015 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - AIDS Research and Therapy LK - https://open.uct.ac.za PY - 2015 SM - 1742-6405 T1 - Sensory neuropathy and metabolic risk factors in human immune deficiency virus infected South Africans receiving protease inhibitors TI - Sensory neuropathy and metabolic risk factors in human immune deficiency virus infected South Africans receiving protease inhibitors UR - http://hdl.handle.net/11427/35120 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/35120
dc.identifier.vancouvercitationVermaak J, Dave JA, Levitt N, Heckmann JM. Sensory neuropathy and metabolic risk factors in human immune deficiency virus infected South Africans receiving protease inhibitors. AIDS Research and Therapy. 2015;12(1):174 - 177. http://hdl.handle.net/11427/35120.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceAIDS Research and Therapy
dc.source.journalissue1
dc.source.journalvolume12
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12981-015-0073-8
dc.subject.otherPolyneuropathies
dc.subject.otherHypertriglyceridemia
dc.subject.otherCells
dc.subject.otherProtease Inhibitors
dc.subject.otherLipids
dc.subject.otherNucleosides
dc.subject.otherRitonavir
dc.subject.otherGlucose
dc.subject.otherReverse Transcriptase Inhibitors
dc.subject.otherLopinavir
dc.subject.otherFasting
dc.subject.otherCD4 Lymphocyte Count
dc.subject.otherArt Therapy
dc.subject.otherRisk Factors
dc.subject.otherRisk
dc.subject.otherCross-Sectional Studies
dc.subject.otherHomo sapiens
dc.subject.otherInfectious Diseases
dc.subject.otherVirology
dc.titleSensory neuropathy and metabolic risk factors in human immune deficiency virus infected South Africans receiving protease inhibitors
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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