HIV-infected patients commonly develop neuropathy. This study examines the association between substance use, neurotoxic antiretrovirals, ethnicity and incident neuropathy in HIV. All data were obtained from the National NeuroAIDS Tissue Consortium. Substance use behaviors were assessed using DSM-IV diagnostic criteria, urine toxicology and inquiry about mode of HIV-infection. Cox proportional hazards models were used to examine the association of substance use, demographic factors and laboratory markers of disease severity (CD4+ count, serum HIV viral load, hemoglobin) with incident neuropathy in 636 participants who were neuropathy-free at baseline. Participants were followed for up to 10.9 years and 261 (41%) developed neuropathy. Substance use (p =.04) and lower hemoglobin (p = .05) were associated with incident neuropathy, but virologic and demographic variables were not. Substance use severe enough to meet criteria for dependence (p = .03) or use of multiple substances (p = .02) were associated with greater risk.
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