CIDP in a HIV endemic population: A prospective case series from Johannesburg, South Africa

Abstract Objective To describe patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) in Johannesburg, South Africa, a setting of high HIV prevalence, and to determine the influence, if any, of HIV on CIDP. Methods Patients were recruited prospectively. The study design was a hospital based case series of unselected consecutive CIDP patients. CIDP was diagnosed according to the European Federation of Neurological Societies/Peripheral Nerve Society criteria for the diagnosis of CIDP (First Revision). Demographic, clinical, laboratory and electrophysiological data were documented. Results Twenty three patients with CIDP were recruited over a two year period. Mean age was 38 years. The female to male ratio was 3.6:1. Less than half (43%) had a raised cerebrospinal fluid (CSF) protein. All patients had idiopathic CIDP, three had associated diabetes mellitus. Ten patients (43%) were HIV positive. Thirteen patients were HIV negative. Clinical and electrophysiological characteristics were identical in the two groups. In the HIV positive group all the patients were black females. The CD4 counts ranged from 87 to 747cells/mm3 . HIV positive status was associated with a progressive disease course and significantly with a CSF lymphocytic pleocytosis (p = 0.007). Albuminocytological dissociation was associated with HIV negative status. Conclusions Testing for HIV in patients with CIDP in a region of high HIV prevalence is recommended. CSF lymphocytic pleocytosis occurs in HIV associated CIDP.