title: Lipodystrophy and adrenal insufficiency: potential mediators of peripheral neuropathy in HIV infection?
abstract: The mechanisms behind certain co-morbid conditions associated with chronic HIV disease still remain elusive. HIV-associated peripheral neuropathy is one among those rarely studied manifestations in HIV-1 infection. Numerous underlying factors associated with peripheral neuropathy have been described in HIV disease. Herein, we hypothesized certain heretofore undescribed potential mechanisms that lead to HIV associated neuropathy. Being a multifactoral manifestation, HIV-associated neuropathy is presumed to have an association with physiological factors namely, adrenal inadequacy/steroid resistance and lipodystrophy-induced cushion-effect loss in peripheral nerves. Therefore, management of the adrenals with steroids at the time-point of high inflammatory burden thereby preventing lipodystrophy by selecting the optimum treatment regimen could markedly alleviate the severity of HIV-associated neuropathic manifestations.
authors.affiliation: Antiretroviral Therapy (ART) Centre, Government Rajaji Hospital, Madurai 625 020, India. drjayakumar1999@gmail.com
authors.forename: Palanisamy
authors.initials: P
authors.lastname: Jayakumar
authors.forename: Esaki Muthu
authors.initials: EM
authors.lastname: Shankar
authors.forename: Murugesan
authors.initials: M
authors.lastname: Karthikeyan
authors.forename: Pandian
authors.initials: P
authors.lastname: Ravikannan
mesh_terms: D000309:Adrenal Insufficiency / Q000188:drug therapy* / Q000209:etiology; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D039682:HIV-Associated Lipodystrophy Syndrome / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008954:Models, Biological; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000517:prevention & control*; D013256:Steroids / Q000627:therapeutic use*
chemical_list: D013256:Steroids