INTRODUCTION : The sensory neuropathies are still prevalent as the most frequent neurological disorder associated with HIV infection and its treatment with ART [1-3]. Ellis et al. [4] reports that distal sensory polyneuropathy is prevalent (57%) in the cART era. There are two major types of HIV-associated distal sensory peripheral neuropathies: primary HIV-associated distal sensory polyneuropathy (HIV-DSP) and ART toxic neuropathy (ATN), together which affect approximately 30–67% of patients with advanced HIV disease [5,6]. The pathology of HIV-DSP involves a length-dependent degeneration of both small and large peripheral nerve bers but the pathogenesis is unknown [6,7,8]. The pathogenesis of ATN is believed to reect inhibition of gamma DNA polymerase by nARTs leading to reduced mitochondrial DNA content and therefore to mitochondrial dysfunction [9]. Reduced mitochondrial DNA levels in subcutaneous fat obtained by punch skin biopsies have been associated with ATN [10,11]. The signs/symptoms of HIV-DSP and ATN resemble common neuropathies encountered in clinical practice including diabetic and alcohol-associated neuropathy. Diabetes mellitus is a common cause of sensory neuropathy, and ART therapy, especially protease inhibitors, is associated with diabetes mellitus [12]. The interaction between metabolic syndrome and HIV is unclear. AIMS : association of HIV neuropathy & its correlation with glycemic status . MATERIAL & METHODS After obtaining prior ethical clearance, treatment naïve PLHA (person living with HIV/acquired immunodeciency syndrome (AIDS)) patients were included in the study and we carried out a cross-sectional study of the HIV seropositive patients in inpatient and outpatient clinic of the Gandhi Medical College, Bhopal, from December 2011 to December 2012. Patients on antitubercular therapy, on antiretroviral therapy, alcoholic, vitamin B-12 deciency, leprosy, chronic kidney disease, and with hereditary neuropathy were excluded from the study. The diagnosis of HIV was made according to National AIDS Control Program Guidelines.[13] Consecutively, each patient underwent a BPNS using the BPNS tool.[14] History and lower extremity examination was done to evaluate patient perception of vibrations for over 10 s using a 128 Hz tuning fork on the big toe. Ankle reexes were also tested using a reex hammer. Sociodemographic and anthropometric information relevant to the study were also obtained from each patient. Fasting blood glucose obtained after 8 hour fast in the morning and postprandial plasma glucose was obtained 2 hour after 82.5 g oral glucose load. STATISTICAL ANALYSIS: Unpaired t-test & chi-square test was used to compare the quantitative variables of interest under study namely; mean hemoglobin, mean body mass index (BMI), mean serum albumin, and mean CD4 T-cell count between clinically evident neuropathy and non-neuropathy group. HIV-SN was dened as the presence of symptoms and at least abnormal perception of vibration or ankle reex or both. Evidence of association was considered for a two-sided P value of less than 0.05. RESULTS : Total number of patients were 75 in number and had mean age , mean weight mean BMI were 33.11±10.45 year , 50.69±9.14 and 18.51±2.71 respectively (table 1). Mean fasting blood glucose was 98.16±14.794 and post 75 g OGTT value were 138.52±19.63.(table1). HIV NEUROPATHY DRUG NAIVE PLHA PATIENTS AND IT'S CORRELATION WITH GLYCEMIC STATUS IN CENTRAL INDIA. Original Research Paper Somnath Singh Raghuvanshi Ex- senior resident depart. Of Endocrinoloy Medical collage & Hospital Kolkata. X 33GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS Endocrinoloy The sensory neuropathies are still prevalent as the most frequent neurological disorder associated with HIV infection and its treatment with ART. There are two major types of HIV-associated distal sensory peripheral neuropathies: primary HIV-associated distal sensory polyneuropathy (HIV-DSP) and ART toxic neuropathy (ATN), together which affect approximately 30–67% of patients with advanced HIV disease. AIM: association of HIV neuropathy & its correlation with glycemic status. MATERIAL & METHODS: After obtaining prior ethical clearance, treatment naïve PLHA (person living with HIV/acquired immunodeciency syndrome (AIDS)) patients were included in the study and we carried out a cross-sectional study of the HIV seropositive patients in inpatient and outpatient clinic of the Gandhi Medical College, Bhopal, from December 2011 to December 2012. RESULTS: Impaired fasting glucose was signicantly higher in neuropathy group by NCS examination (61.9%) than non- neuropathy group (31.2%), p=0.009 . Impaired glucose tolerance is signicantly higher in clinical neuropathy group (75.9%) than non-neuropathy group (28.3%), p=0.009. CONCLUSION : The dysglycemia is more common in the hiv patients and both dysglycemia and hiv associated with neuropathy or hiv patients are more prone to dysglycemia. ABSTRACT KEYWORDS : Human Immunodefeciency Virus , Plha , Nerve Conduction Study . Dysglycemia. Tribhuvan Nath Dubey* Dean & Ex HOD depart. Of medicene, Gandhi Medical Collage Bhopal *Corresponding Author Himanshu Sharma Assistant Professor depart. Of medicine , Gandhi Medical College Bhopal Rita Saxena Assistant Professor depart. Of medicine Gandhi Medical College Bhopal VOLUME-9, ISSUE-1, JANUARY-2020 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra Table : 1 Baseline characteristics N Minimum Maximum Mean Std. Deviation AGE 75 18 60 33.11 10.454 34 X GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS The neuropathy was present with both impaired fasting glucose and impaired postprandial glucose load and thre was signicant difference among fasting (p<0.001) in patient with neuropathy with similar signicance level in the post prandial glucose.(table02). : Both FBS and 75 OGTT were signicantly higher in Neuropathy present group than non-neuropathy group as determined by unpaired t-test. Both FBS and 75 OGTT were signicantly higher in clinical neuropathy present group than non-neuropathy group as determined by unpaired t-test.(TABLE03) Impaired fasting glucose is signicantly higher in neuropathy group by NCS examination (61.9%) than non-neuropathy group (31.2%), p=0.009 as determined by chi-square test.(Table:04) Impaired glucose tolerance is signicantly higher in neuropathy group (61.9%) than non-neuropathy group (25%), p=0.009 as determined by chi-square test.(table05) Impaired glucose tolerance is signicantly higher in clinical neuropathy group (75.9%) than non-neuropathy group (28.3%), p=0.009 as determined by chi-square test. DISCUSSION : In the our study 56.7 % patients had abnormal nerve conduction study with both impaire fasting plasma glucose as well as with impaired glucose tolerance . Impaired fasting glucose was signicantly higher in neuropathy group by NCS examination (61.9%) than non-neuropathy group (31.2%). The clinical neuropathy was present in the 38.8% of the patient with dysglycemia. Diabetes reected by insulin use also predicts less chance for reversal of symptomatic neuropathy, suggesting that combining the diabetic risk with nART-induced mitochondrial decits may be a particularly troublesome neurotoxic situation. Early studies emphasized CD4 and viral load as risk factors, but with successful therapy these associations have become less important. Specically viral suppression did not decrease the odds of peripheral neuropathy. Although neuropathy was more common in the PLHA patient with dysglycemia but it is difcult to comment on the etiology of neuropthy because both HIV and dysglycemia causes neuropthy & also PLHA patient are prone to dysglycemia . CONCLUSION : The dysglycemia is more common in the hiv patients and both dysglycemia and hiv associated with neuropathy or hiv patients are more prone to dysglycemia. ACKNOWLEDGEMENT : thank to my respected teachers and ARTplus center GMC bhopal. CONFLICT OF INTEREST : None . REFERENCE : 1. Keswani SC, Pardo CA, Cherry CL, Hoke A, McArthur JC. HIV-associated sensory neuropathies. AIDS. 2002; 16:2105–2117. [PubMed: 12409731] 2. Bacellar H, Munoz A, Miller EN, Cohen BA, Besley D, Selnes OA, et al. Temporal trends in the incidence of HIV-1-related neurologic diseases: Multicenter AIDS Cohort Study, 1985–1992. Neurology. 1994; 44:1892–1900. [PubMed: 7936243] 3. McArthur JC, Brew BJ, Nath A. Neurological complications of HIV infection. Lancet Neurol. 2005; 4:543–555. [PubMed: 16109361] 4. Ellis, R.; Rosario, D.; Clifford, D.; McArthur, J.; Simpson, D.; Alexander, T., et al. CROI. Montreal, Canada: 2009. Persisting high prevalence of HIV distal sensory peripheral neuropathy in the era of cART: correlates in the CHARTER study. [Paper #461] 5. Wulff EA, Wang AK, Simpson DM. HIV-associated peripheral neuropathy: epidemiology, pathophysiology and treatment. 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VOLUME-9, ISSUE-1, JANUARY-2020 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra WEIGHT 75 34 82 50.69 9.143 FBS 75 67 124 98.16 14.794 75 OGTT 75 102 188 138.52 19.634 HEIGHT 75 145 178 165.29 8.160 BMI 75 13 27 18.51 2.713 Table:02 Neuropathy(NCS) and dysglycemia Study Variable Neuropathy by NCS Examination N Mean Std. Deviation p FBS Present 42 103.74 13.520 <0.001 Absent 32 90.69 13.422 75 OGTT Present 42 146.45 20.502 <0.001 Absent 32 128.03 12.855 Table :03 CLINICAL NEUROPATHY Clinical neuropathy N Mean Std. Deviation p FBS Present 29 106.83 11.793 <0.001 Absent 46 92.70 13.944 75 OGTT Present 29 149.41 19.778 <0.001 Absent 46 131.65 16.304 TABLE 04 :Neuropathy by NCS Examination * IFG Crosstabulation IFG Total p Absent Present Neuropathy by NCS Examination Present Count 16 26 42 0.009 % 38.1% 61.9% 100.0% Absent Count 22 10 32 % 68.8% 31.2% 100.0% Total Count 38 36 74 % 51.4% 48.6% 100.0% Table:05 Neuropathy by NCS Examination * IGT Crosstabulation IGT Total p Absent Present Neuropathy by NCS Examination Present Count 16 26 42 0.002 % 38.1% 61.9% 100.0% Absent Count 24 8 32 % 75.0% 25.0% 100.0% Total Count 40 34 74 % 54.1% 45.9% 100.0%