TY - JOUR
T1 - Selected peripheral neuropathies associated with human immunodeficiency virus infection and antiretroviral therapy
AU - Simpson, David M.
PY - 2002
Y1 - 2002
N2 - A variety of peripheral neuropathies are associated with human immunodeficiency virus (HIV) infection. Although the incidence of certain forms of neuropathy is increased in HIV infection, in other cases, the association may be fortuitous. Different forms of peripheral neuropathy occur with increased frequency at particular stages of HIV disease. For example, inflammatory demyelinating neuropathy (IDP) is often the first manifestation of HIV disease, when CD4 lymphocyte counts are relatively high. As immunosuppression progresses and HIV viral load becomes uncontrolled, the incidence of distal symmetrical polyneuropathy (DSP) increases. In advanced stages of HIV disease (CD4 count <50 cells/mm3), patients may develop opportunistic cytomegalovirus (CMV) nerve infection, which can present as progressive polyradiculopathy (PP) or mononeuropathy multiplex (MM). In addition to the neuromuscular disorders caused by HIV and its concomitant immunosuppression, the use of antiretroviral (ARV) drugs and other therapeutic agents in HIV disease is frequently limited by neuromuscular side effects. This paper will review the symmetrical forms of polyneuropathy that occur in association with HIV infection and nucleoside analogue therapy. The clinical, electrophysiologic, and pathologic features of these disorders will be described along with a discussion of theories of pathogenesis and results of treatment to date.
AB - A variety of peripheral neuropathies are associated with human immunodeficiency virus (HIV) infection. Although the incidence of certain forms of neuropathy is increased in HIV infection, in other cases, the association may be fortuitous. Different forms of peripheral neuropathy occur with increased frequency at particular stages of HIV disease. For example, inflammatory demyelinating neuropathy (IDP) is often the first manifestation of HIV disease, when CD4 lymphocyte counts are relatively high. As immunosuppression progresses and HIV viral load becomes uncontrolled, the incidence of distal symmetrical polyneuropathy (DSP) increases. In advanced stages of HIV disease (CD4 count <50 cells/mm3), patients may develop opportunistic cytomegalovirus (CMV) nerve infection, which can present as progressive polyradiculopathy (PP) or mononeuropathy multiplex (MM). In addition to the neuromuscular disorders caused by HIV and its concomitant immunosuppression, the use of antiretroviral (ARV) drugs and other therapeutic agents in HIV disease is frequently limited by neuromuscular side effects. This paper will review the symmetrical forms of polyneuropathy that occur in association with HIV infection and nucleoside analogue therapy. The clinical, electrophysiologic, and pathologic features of these disorders will be described along with a discussion of theories of pathogenesis and results of treatment to date.
KW - Antiretroviral toxicity
KW - HIV infection
KW - Peripheral neuropathy
UR - http://www.scopus.com/inward/record.url?scp=0036948086&partnerID=8YFLogxK
U2 - 10.1080/13550280290167939
DO - 10.1080/13550280290167939
M3 - Review article
C2 - 12491149
AN - SCOPUS:0036948086
SN - 1355-0284
VL - 8
SP - 33
EP - 41
JO - Journal of NeuroVirology
JF - Journal of NeuroVirology
IS - SUPPL. 2
ER -