Peripheral neuropathy in HIV: an analysis of evidence-based approaches.
Peripheral neuropathy is a common and vexing symptom for people living with HIV infection (PLWH). Neuropathy occurs in several different syndromes and is identified in the literature as distal sensory polyneuropathy or distal sensory peripheral neuropathy. More recently, the HIV literature has focused on the syndrome as painful HIV-associated sensory neuropathy, addressing the symptom rather than the underlying pathophysiology. Assessment of neuropathy in PLWH is critical and must be incorporated into nursing practice for each visit. Neuropathy has been attributed to the direct effects of HIV, exposure to antiretroviral medications (particularly the nucleoside reverse transcriptase inhibitors), advanced immune suppression, and comorbid tuberculosis infection and exposure to antituberculosis medications. Evidence supports the importance of addressing neuropathy in PLWH with pharmacologic treatment regimens and complementary/alternative approaches. This paper examines the pathophysiology, evidence, and approaches to managing peripheral neuropathy. A case study has been included to illustrate a patient's experience with neuropathy symptoms.
Patrice K
PK
Nicholas
Inge B
IB
Corless
Linda A
LA
Evans
D000588:Amines / Q000627:therapeutic use*; D044966:Anti-Retroviral Agents / Q000009:adverse effects*; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use*; D016049:Didanosine / Q000009:adverse effects; D019317:Evidence-Based Medicine; D000077206:Gabapentin; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy* / Q000503:physiopathology* / Q000821:virology; D018119:Stavudine / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use*
D000588:Amines; D044966:Anti-Retroviral Agents; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D018119:Stavudine; D016049:Didanosine
HIV; distal sensory peripheral neuropathy; distal sensory polyneuropathy; nursing; peripheral neuropathy