Abstract Details

Title The Association Between Chronic Distal Sensory Polyneuropathy and Balance Disturbances in Persons Living with HIV

Topic Infectious Disease

Presentation(s) S29 - NeuroHIV: Pathophysiology and Clinical Phenotypes (4:14 PM-4:25 PM)

Poster/Presentation
Number 005

Background In older PLWH, there is an interaction between aging-related and HIV-specific issues, and this interaction results in increased fall risk. The contribution of neuropathy to balance disturbance and fall risk is understudied.

Objective To evaluate the contribution of chronic distal sensory polyneuropathy (cDSPN) to balance disturbances among persons living with HIV (PLWH).

Design/Methods

Ambulatory PLWH and HIV- adults (N=3,379) underwent a neurologic examination to document objective abnormalities diagnostic of cDSPN and reported neuropathy symptoms including pain, paresthesias and numbness. Participants provided detailed information regarding balance disturbance and falls over the previous ten years. Balance disturbances were coded as ‘minimal or none’ and ‘mild to moderate.’ Covariates included age, HIV disease and treatment characteristics and medications (sedatives, opiates, antihypertensives).

Results Eleven percent of participants reported balance disturbances at some time during the last ten years, with PLWH experiencing balance disturbance at rates more than two-fold those of persons without HIV (odds ratio [OR]=2.7). Fifty-two percent of PLWH met criteria for cDSPN, and balance problems were more common among PLWH with cDSPN (OR=3.3, 95% CI 2.6-4.3). Adjusting for relevant covariates, balance disturbances attributable to cDSPN were more frequent among PLHW than persons without HIV (interaction p=0.001). Among individuals with cDSPN, older participants were much more likely to report balance disturbances than younger ones.

Conclusions cDSPN contributes to balance problems in PLWH. Assessments of cDSPN in older PLWH should be a clinical priority to identify those at-risk for falls and to aid in fall prevention and the ensuing consequences, including bone fractures, subdural hematoma, hospital admissions and fatal injury.

Authors/Disclosures
Duaa Sakabumi PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Patrick A. Delaney, MD (UCSD Medical Center)	No disclosure on file
John L. Keltner, MD (UC Davis Department of Ophthalmology)	No disclosure on file
Ronald J. Ellis, MD, PhD, FAAN (UC San Diego)	Dr. Ellis has nothing to disclose.

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