Disability, fatigue and peripheral neuropathy in adolescents with perinatal HIV infection

ABSTRACT

Perinatally HIV-infected adolescents (PHIVA) experience many physical sequelae, but little is known about their levels of disability, fatigue or peripheral neuropathy. This study aimed to determine these sequelae through a cross-sectional analysis in a population of PHIVA and HIV-negative adolescents, based in Johannesburg, South Africa. Outcome measures used were the HIV-related Fatigue Scale, World Health Organization Disability Assessment Schedule 2.0 and the Brief Peripheral Neuropathy Screen, to measure fatigue, level of disability and peripheral neuropathy, respectively. Of the 249 participants assessed, 59% (n = 147) were PHIVA, and the mean age of the participants was 12 years. Clinical data for the PHIVA group showed that the majority (87.1%) were virally suppressed. When compared to the HIV-negative group, PHIVA presented with significantly greater levels of fatigue intensity [1.2(SD±0.5) vs. 1.5(SD±0.9) p = 0.022] and disability [9.2(±6.8) vs. 11.5(±8.9) p = 0.023], with specific limitations in mobility, self-care and participation. No significant differences in peripheral neuropathy were found. In conclusion, PHIVA face challenges with disability and fatigue highlighting the necessity of comprehensive management for this population.

KEYWORDS:

• HIV
• perinatal
• adolescence
• disability
• fatigue

Acknowledgments

The authors wish to acknowledge the key role that Mduduzi Linganisa and Raphael Christopher played as research assistants in this study. Additionally, the research site, staff, participants and caregivers all made the study possible through their willingness and involvement.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Nicolette Comley-White. The first draft of the manuscript was written by Nicolette Comley-White and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Consent

All caregivers and children signed consent and assent, respectively.

Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Ethics approval

Approval was obtained from the Human Research Ethics Committee (Medical) of the University of the Witwatersrand (M180226). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

Additional information

Funding

Funding for this study was obtained through the South African Society of Physiotherapy and the University of the Witwatersrand.