HIV-associated peripheral neuropathies.

Title
Human immunodeficiency virus-associated peripheral neuropathies.
Source
Mayo Clinic Proceedings. 81(2):213-9, 2006 Feb.

The availability of potent antiretroviral drugs and their use in 3 or more combination regimens, highly active antiretroviral therapy (HAART), have led to a substantial decline in the morbidity and mortality associated with human immunodeficiency virus (HIV) infection. Although a similar overall decline has occurred in the incidence and prevalence of central nervous system complications, peripheral neuropathy (PN) continues to be a common neurologic complication at every stage of HIV infection. The spectrum of peripheral involvement in HIV infection includes distal symmetrical polyneuropathy (DSP), toxic neuropathy from antiretroviral drugs, diffuse infiltrative lymphocytosis syndrome (DILS), inflammatory demyelinating polyneuropathies (IDPs), multifocal mononeuropathies, and progressive polyradiculopathy. Diagnosis and treatment of PN in the HAART era represent a challenge even for expert neurologists and consultants in infectious diseases because of the overlap of clinical symptoms, complexity of treatment choices, and a possible abnormal presentation of symptoms of PN during immune reconstitution, when the CD4 T-lymphocyte count is rising.

"Peripheral neuropathy has emerged as the most common neurologic complication of human immunodeficiency virus (HIV) infection. It will continue to play an Important role in HIV Infection given the fact that HIV-infected Individuals are living longer, are at risk of long-term metabolic complications, and face an Increasing exposure to potentially neurotoxic antiretroviral drugs. We review the various types of peripheral neuropathy that have been associated with HIV infection, including distal symmetrical polyneuropathy, toxic neuropathy from antiretroviral drugs, diffuse infiltrative lymphocytosis syndrome, inflammatory demyelinating polyneuropathies, multifocal mononeuropathies, and progressive polyradiculopathy."