title: Understanding the etiology and management of HIV-associated peripheral neuropathy.
abstract: HIV may cause several forms of peripheral neuropathy, the most common of which is distal symmetric polyneuropathy (DSP) characterized by pain and sensory deficits in a stocking-glove distribution. The pathophysiology of DSP remains largely unknown but is thought to be related both to the neurotoxicity of HIV-through indirect immunomodulatory mechanisms-and to the neurotoxic effects of anti-retroviral therapies, most notably the dideoxynucleoside reverse transcription inhibitors or so-called d-drugs. Determining whether symptoms arise from the virus or the treatment poses a challenge to the clinician who must decide if a patient's HAART regimen should be altered. Treatment of symptoms related to HIV-DSP is a difficult task and there is no evidence that the traditional agents used in chronic neuropathic pain are efficacious in the HIV-DSP population. Indeed few pharmacologic agents have proven efficacy in HIV-DSP - these include cannabis and the capsaicin 8 % dermal patch. As such, alternative, non-pharmacologic therapies are being investigated. More research is needed to further elucidate the complex pathophysiology of HIV-DSP which may yield additional therapies for these patients.
authors: Department of Neurology, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue Annenberg 2nd Floor, Box 1052, New York, NY, 10029, USA.
authors: Kara
authors: K
authors: Stavros
authors: David M
authors: DM
authors: Simpson
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D044966:Anti-Retroviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy / Q000209:etiology*; D012307:Risk Factors
chemical_list: D000893:Anti-Inflammatory Agents; D044966:Anti-Retroviral Agents