Neuromuscular complications of the human immunodeficiency virus type 1 infection

Neuromuscular disorders are the most frequent neurologic complications associated with human immunodeficiency virus (HIV) infection and AIDS. Although neurologic disorders are frequently overlooked, they add considerable morbility and mortality to patients with HIV infection. It is critically important to properly diagnose and treat these neuromuscular complications, which leads to substantial improvement in patients' quality of life. Distal symmetric polyneuropathy is the most common form of peripheral neuropathy in HIV infection. It occurs mainly in patients with advanced immunosuppression and may also result from the neurotoxicity of several antiretroviral agents. Myopathy may occur at any stage of HIV disease and has also been described as a toxic side effect of zidovudine. Here we review the clinical features, diagnostic approach, and pathogenetic mechanisms of the neuromuscular complications of HIV infection. We also discuss management strategies and the results of clinical trials for the treatment of these disorders.