title: HIV-associated neuromuscular weakness syndrome in Brazil: report of the two first cases.
abstract: We describe two Brazilian patients with HIV-associated neuromuscular weakness syndrome (HANWS), a unique clinical toxic syndrome that was recently reported in developed countries. Both patients were women, used stavudine and had hyperlactatemia, one of them with lactic acidosis. Electrophysiological studies were consistent with axonal neuropathy. After discontinuation of antiretroviral therapy the patients had significant improvement in neurologic manifestations, and normalization of lactate levels. To our knowledge, this is the first report of HANWS in developing countries. Growing use of antiretroviral therapy in this setting, particularly stavudine, make it likely that similar cases will be observed.
authors.affiliation: Departamento de Neurologia, Instituto de Infectologia Emílio Ribas, Rua Capote Valente 668/78, 05409-002 São Paulo, SP, Brazil. josevibe@gmail.com
authors.forename: José E
authors.initials: JE
authors.lastname: Vidal
authors.forename: David
authors.initials: D
authors.lastname: Clifford
authors.forename: Cláudio Meilman
authors.initials: CM
authors.lastname: Ferreira
authors.forename: Augusto C Penalva de
authors.initials: AC
authors.lastname: Oliveira
mesh_terms: D000140:Acidosis, Lactic / Q000139:chemically induced*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D018908:Muscle Weakness / Q000139:chemically induced* / Q000175:diagnosis; D019562:Viral Load