Neuropathy and Ethnic Origin

It has been suggested elsewhere that more men with HIV contract neuropathy than women and now, this article from The Aids Beacon (see link below) goes further and looks at a study of almost a thousand cases, which shows that more African-American women are prone to neuropathy than other ethnic women's groups.
Do we assume from this that the statistics apply to all black, hispanic, and white women? And what about Asian and other ethnic group women? An article like this always raises more questions than answers and for that reason can be useful in starting discussions and triggering research. It leaves you wondering if it's true that HIV+ women are less likely to get neuropathy than HIV+ men and if so, why? and very importantly, how much the results are based on social and physical environments. Are African-American women more likely to get neuropathy than their African, or even South American counterparts for instance? If anyone can shed further light on these questions, please let us all know. Further than that, it's clear that this is yet another area of neuropathy where much more research and conclusions are needed. Such results may help particular groups in their searches for useful information.

HIV-Associated Neuropathy Is More Common In African-American Women
By Kieryn Graham
Published: Dec 8, 2011

Results from a recent study indicate that the rate of HIV-associated neuropathy in women may be lower than previously thought but higher in African-American women than in women of other races.

Over a third of the HIV-positive women in the study had neuropathy. African-American women were about two thirds more likely to have neuropathy than women of other races.

“Why neuropathy is more prevalent [in African-American women] is unclear, and there is little data on any association between neuropathy and race (not just HIV neuropathy),” said Dr. Yaacov Anziska, from the Department of Neurology at SUNY-Downstate Medical Center in Brooklyn, New York and lead author of the study.

“Clinicians and care providers should investigate for neuropathy in African-American women with HIV/AIDS. This entails both asking patients about pain, numbness, and tingling in their feet, as well as checking reflexes and sensation on clinical examination,” he added.

HIV-associated neuropathy is a nerve condition characterized by chronic pain in the hands and feet and sometimes the loss of sensation in the arms and legs.

Researchers estimate that the condition affects about half of all people with HIV. It can be caused by both HIV infection and by some HIV treatments, particularly the older nucleoside reverse transcriptase inhibitors (NRTIs) didanosine (Videx) and stavudine (Zerit).

According to the study authors, previous studies have linked low CD4 (white blood cell) counts, high viral loads (amount of HIV in the blood), diabetes, and older age with a higher risk of HIV-associated neuropathy. However, the effects of race and gender on risk of neuropathy have not been well studied.

The study included 973 HIV-positive women. Nine percent of the women were Caucasian, 64 percent were African-American, and 20 percent were Hispanic. Seventeen percent of the women had hepatitis C in addition to HIV, 21 percent had diabetes, and 17 percent were heavy alcohol users. The average age was 42 years old.

Results showed that 36 percent of the women had HIV-associated neuropathy; 21 percent of the women with neuropathy were Hispanic and 67 percent were African-American. By comparison, 31 percent and 53 percent of women without neuropathy were Hispanic and African-American, respectively.

In addition, 39 percent of women with HIV-associated neuropathy had hepatitis C, compared to 22 percent of HIV-positive women without neuropathy. Over 26 percent of women with neuropathy were diabetic, compared to 16 percent of HIV-positive women without neuropathy.

Overall, the researchers calculated that HIV-positive women with hepatitis C or diabetes were about 1.4 times more likely to have HIV-associated neuropathy than HIV-positive women without these conditions. In addition, older age was linked to a 30 percent higher risk of HIV-associated neuropathy, and African-American race with a 67 percent higher risk.

The researchers found that there was no significant effect of alcohol use on risk of neuropathy. They also found, contrary to previous studies, that height, CD4 cell counts, viral loads, or use of older NRTIs such as didanosine and stavudine had no effect on risk of neuropathy in this study.

They speculated that this was due to a shorter average height, relatively high CD4 counts, and minimal use of older NRTIs by the women who participated in the study.

http://www.aidsbeacon.com/news/2011/12/08/hiv-aids-associated-neuropathy-is-more-common-in-african-american-women/