Prevalence of sensory neuropathy and its association with motor function and health-related quality of life in children living with HIV in South Africa

Abstract Background Paediatric HIV remains common in South Africa, and sensory neuropathy (SN) is a recognised complication of HIV infection. The prevalence of SN in children is not well documented in South Africa, even though HIV-related SN is expected to increase as more children survive longer in the antiretroviral treatment (ART) era. This study aimed to determine the prevalence of SN in children living with HIV (CLWHIV) and its effect on motor ability and health-related quality of life (HRQoL). Methods This was a prospective cross-sectional cohort study. Children (3–10 years) infected with HIV and attending the Rahima Moosa Mother and Child Hospital, Johannesburg, South Africa, were screened for signs (pin-prick sensitivity, vibration sense, ankle-jerk reflexes) and symptoms (pain, numbness, paraesthesia) of SN using an adapted Brief Peripheral Neuropathy Screen. Participants completed the Paediatric Quality of Life Questionnaire (PedsQL) and their motor function was assessed using the Movement ABC-2. Basic anthropometric, socio-demographic, medical, and ART information was recorded. Results One hundred and thirty-five children with a mean age of 6.9 (± 1.7) years were assessed (range 3.26–10.54 years). Thirty-six participants tested positive for SN (point prevalence 25.9%); 24.1% reported previous symptoms and 7.8% reported current symptoms. Using a stricter case definition requiring both a sign and a symptom, five children (3.7% of the total sample) were classified as having symptomatic SN: all five reported previous pain, and four had current pain. Conclusions The prevalence of HIV-SN was high in this paediatric population, most of whom were asymptomatic and largely undiagnosed prior to this study. Of those who presented with SN, 23% were in the red (delayed) category of gross motor function on the M-ABC-2, 39% were amber (at risk), and 48% were green (typically developing).