[Sensory neuropathy in HIV infection: pathogenesis and therapy].
An axonal sensory neuropathy is a frequent complication in the course of HIV infection; more than 30% of all HIV-infected individuals will develop a polyneuropathy. Low CD4 cell counts and high HIV RNA loads increase the risk. This neuropathy causes pain, paresthesias and burning sensations and/or numbness in the feet, which sometimes occurs in the hands as well. Neurological examination reveals sensory deficits in a stocking and glove distribution and depressed or absent ankle reflexes, without severe paresis. The cause of the sensory neuropathy is unknown. Either the HIV infection or certain other infections, for example cytomegalovirus, may play a role in the pathogenesis; vasculitis may be a process associated with this. Some antiretroviral drugs within the nucleoside analogue group cause a neuropathy but the pathogenesis of this remains unclear. Amitriptyline, tramadol and carbamazepine can be used for symptomatic treatment. The efficacy of lamotrigine and gabapentin has yet to be confirmed.
Portegies
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Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Neurologie, Postbus 22.700, 1100 DE Amsterdam.
Rosenberg
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D000639:Amitriptyline / Q000627:therapeutic use; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002220:Carbamazepine / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D006987:Hypesthesia / Q000821:virology; D010292:Paresthesia / Q000821:virology; D011115:Polyneuropathies / Q000188:drug therapy* / Q000821:virology*; D014147:Tramadol / Q000627:therapeutic use
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000929:Antidepressive Agents, Tricyclic; D000639:Amitriptyline; D002220:Carbamazepine; D014147:Tramadol