HIV-related neuropathy: current perspectives

Sonja G Schütz, Jessica Robinson-Papp Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA Abstract: Distal symmetric polyneuropathy (DSP) related to human immunodeficiency virus (HIV) is one of the most common neurologic complications of HIV, possibly affecting as man...

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Autores principales:	Sch&uuml;tz SG, Robinson-Papp J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/3d31e4fb17264e458c75945e76080be9
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spelling	oai:doaj.org-article:3d31e4fb17264e458c75945e76080be92021-12-02T03:23:56ZHIV-related neuropathy: current perspectives1179-1373https://doaj.org/article/3d31e4fb17264e458c75945e76080be92013-09-01T00:00:00Zhttp://www.dovepress.com/hiv-related-neuropathy-current-perspectives-a14310https://doaj.org/toc/1179-1373Sonja G Schütz, Jessica Robinson-Papp Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA Abstract: Distal symmetric polyneuropathy (DSP) related to human immunodeficiency virus (HIV) is one of the most common neurologic complications of HIV, possibly affecting as many as 50% of all individuals infected with HIV. Two potentially neurotoxic mechanisms have been proposed to play a crucial role in the pathogenesis of HIV DSP: neurotoxicity resulting from the virus and its products; as well as adverse neurotoxic effects of medications used in the treatment of HIV. Clinically, HIV DSP is characterized by a combination of signs and symptoms that include decreased deep tendon reflexes at the ankles and decreased sensation in the distal extremities as well as paresthesias, dysesthesias, and pain in a symmetric stocking–glove distribution. These symptoms are generally static or slowly progressive over time, and depending on the severity, may interfere significantly with the patient's daily activities. In addition to the clinical picture, nerve conduction studies and skin biopsies are often pursued to support the diagnosis of HIV DSP. Anticonvulsants, antidepressants, topical agents, and nonspecific analgesics may help relieve neuropathic pain. Specifically, gabapentin, lamotrigine, pregabalin, amitriptyline, duloxetine, and high-dose topical capsaicin patches have been used in research and clinical practice. Further research is needed to elucidate the pathogenesis of HIV DSP, thus facilitating the development of novel treatment strategies. This review discusses the epidemiology, pathophysiology, clinical findings, diagnosis, and management of DSP in the setting of HIV. Keywords: neuropathy, human immunodeficiency virus, acquired immunodeficiency syndrome, AIDS, distal symmetric polyneuropathy, DSP, painSch&uuml;tz SGRobinson-Papp JDove Medical PressarticleImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol 2013, Iss default, Pp 243-251 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Immunologic diseases. Allergy RC581-607
spellingShingle	Immunologic diseases. Allergy RC581-607 Sch&uuml;tz SG Robinson-Papp J HIV-related neuropathy: current perspectives
description	Sonja G Schütz, Jessica Robinson-Papp Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA Abstract: Distal symmetric polyneuropathy (DSP) related to human immunodeficiency virus (HIV) is one of the most common neurologic complications of HIV, possibly affecting as many as 50% of all individuals infected with HIV. Two potentially neurotoxic mechanisms have been proposed to play a crucial role in the pathogenesis of HIV DSP: neurotoxicity resulting from the virus and its products; as well as adverse neurotoxic effects of medications used in the treatment of HIV. Clinically, HIV DSP is characterized by a combination of signs and symptoms that include decreased deep tendon reflexes at the ankles and decreased sensation in the distal extremities as well as paresthesias, dysesthesias, and pain in a symmetric stocking–glove distribution. These symptoms are generally static or slowly progressive over time, and depending on the severity, may interfere significantly with the patient's daily activities. In addition to the clinical picture, nerve conduction studies and skin biopsies are often pursued to support the diagnosis of HIV DSP. Anticonvulsants, antidepressants, topical agents, and nonspecific analgesics may help relieve neuropathic pain. Specifically, gabapentin, lamotrigine, pregabalin, amitriptyline, duloxetine, and high-dose topical capsaicin patches have been used in research and clinical practice. Further research is needed to elucidate the pathogenesis of HIV DSP, thus facilitating the development of novel treatment strategies. This review discusses the epidemiology, pathophysiology, clinical findings, diagnosis, and management of DSP in the setting of HIV. Keywords: neuropathy, human immunodeficiency virus, acquired immunodeficiency syndrome, AIDS, distal symmetric polyneuropathy, DSP, pain
format	article
author	Sch&uuml;tz SG Robinson-Papp J
author_facet	Sch&uuml;tz SG Robinson-Papp J
author_sort	Sch&uuml;tz SG
title	HIV-related neuropathy: current perspectives
title_short	HIV-related neuropathy: current perspectives
title_full	HIV-related neuropathy: current perspectives
title_fullStr	HIV-related neuropathy: current perspectives
title_full_unstemmed	HIV-related neuropathy: current perspectives
title_sort	hiv-related neuropathy: current perspectives
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/3d31e4fb17264e458c75945e76080be9
work_keys_str_mv	AT schampuumltzsg hivrelatedneuropathycurrentperspectives AT robinsonpappj hivrelatedneuropathycurrentperspectives
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HIV-related neuropathy: current perspectives

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