Current HIV/AIDS Reports

, Volume 11, Issue 3, pp 195–201 | Cite as

Understanding the Etiology and Management of HIV-Associated Peripheral Neuropathy

  • Kara Stavros
  • David M. Simpson
Complications of Antiretroviral Therapy (JM Kilby, Section Editor)


HIV may cause several forms of peripheral neuropathy, the most common of which is distal symmetric polyneuropathy (DSP) characterized by pain and sensory deficits in a stocking-glove distribution. The pathophysiology of DSP remains largely unknown but is thought to be related both to the neurotoxicity of HIV—through indirect immunomodulatory mechanisms—and to the neurotoxic effects of anti-retroviral therapies, most notably the dideoxynucleoside reverse transcription inhibitors or so-called d-drugs. Determining whether symptoms arise from the virus or the treatment poses a challenge to the clinician who must decide if a patient’s HAART regimen should be altered. Treatment of symptoms related to HIV-DSP is a difficult task and there is no evidence that the traditional agents used in chronic neuropathic pain are efficacious in the HIV-DSP population. Indeed few pharmacologic agents have proven efficacy in HIV-DSP – these include cannabis and the capsaicin 8 % dermal patch. As such, alternative, non-pharmacologic therapies are being investigated. More research is needed to further elucidate the complex pathophysiology of HIV-DSP which may yield additional therapies for these patients.


HIV Peripheral neuropathy Distal symmetric polyneuropathy, DSP Anti-retroviral Pain 


Compliance with Ethics Guidelines

Conflict of Interest

Kara Stavros declares that she has no conflict of interest.

David M. Simpson reports personal fees from Astellas, Acorda, Pfizer, Depomed, grants from Astellas, Pfizer, and outside the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkUSA

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