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Managing HIV peripheral neuropathy

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Abstract

Peripheral nerve disorders are frequent complications of HIV disease. Distal symmetrical polyneuropathy (DSP) is the most common peripheral nerve disorder associated with HIV and occurs in over one third of infected patients but may occur in up to 67% if asymptomatic patients are included. Risk factors for DSP include increased age, advanced HIV disease, and history of “d-drugs” or other neurotoxic drugs. The primary manifestations of polyneuropathy are slowly progressive numbness and paresthesias, with burning sensations in the feet usually in a symmetrical pattern. The etiology of HIV-associated DSP is unknown, although neurotoxic effects of cytokines, toxicity of HIV proteins, and mitochondrial damage have been implicated. The current treatment for HIV-associated DSP is symptomatic, with pain modifying medications, including anti-inflammatory agents, opioids, antidepressants, antiepileptics, topical anesthetics, and capsaicin. Sustained virologic control may improve DSP. Novel therapies such as acetyl-l-carnitine or neurotrophic factors are being studied for treatment of DSP.

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Authors and Affiliations

  1. Department of Clinical Neurophysiology, Mount Sinai School of Medicine, Annenberg 2nd Floor, Box 1052, New York, NY, 10029, USA

    David M. Simpson MD

Authors
  1. Alejandra Gonzalez-Duarte MD
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  2. Katia Cikurel MD
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  3. David M. Simpson MD
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Correspondence to David M. Simpson MD.

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Gonzalez-Duarte, A., Cikurel, K. & Simpson, D.M. Managing HIV peripheral neuropathy. Curr HIV/AIDS Rep 4, 114–118 (2007). https://doi.org/10.1007/s11904-007-0017-6

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  • DOI: https://doi.org/10.1007/s11904-007-0017-6

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