Lower-extremity Dynamometry as a Novel Outcome Measure in a Double-blind, Placebo-controlled, Feasibility Trial of Intravenous Immunoglobulin (IVIG) for HIV-associated Myelopathy

Conclusion: We conclude that an adequately powered clinical trial of IVIG for HIVM would likely require a prolonged recruitment period and multiple participating sites. Lower limb dynamometry is a useful outcome measure for HIVM, which might also be useful in other HIV-related gait disorders. KEYWORDS: Dynamometry, intravenous immunoglobulin (IVIG), human immunodeficiency virus (HIV), myelopathy INTRODUCTION Human immunodeficiency virus (HIV)-associated myelopathy (HIVM) is a rare but well-described neurologic complication of HIV; it was first described early in the acquired immunodeficiency syndrome (AIDS) epidemic, and is still observed today despite the widespread use of combination antiretroviral therapy (CART).[1–3] HIVM manifests clinically at any stage of HIV infection, with slowly progressive weakness in the lower extremities, gait disorder, sensory abnormalities in the legs, sexual dysfunction, and urinary and bowel control abnormalities.[4] There is currently no proven effective treatment for HIVM, and treatment focuses on symptomatic therapies, including antispasticity agents, management of sphincter dysfunction, and physical therapy. The pathogenesis of HIVM is unknown. HIV itself has been detected in the spinal cord only rarely, and there is no correlation between the presence or severity of HIVM and the presence of HIV in the spinal cord, CD4+ lymphocyte cell count, or HIV viral load in plasma or cerebrospinal fluid.[5,6] The histopathology of HIVM bears some ...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Assessment Tools Current Issue Demyelinating Disease Movement Disorders Neurodegenerative Disease Neurology Original Research Primary Care Technology Trial Methodology Dynamometry human immunodeficiency virus (HIV) intravenous immu Source Type: research