Understanding the Etiology and Management of HIV-associated Peripheral Neuropathy

Overview

Journal Curr HIV/AIDS Rep

Publisher Current Science

Specialty Infectious Diseases

Date 2014 Jun 28

PMID 24969360

Citations 21

Authors

Kara Stavros

David M Simpson

Affiliations

Soon will be listed here.

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.

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References

Evans S, Simpson D, Kitch D, King A, Clifford D, Cohen B . A randomized trial evaluating Prosaptide for HIV-associated sensory neuropathies: use of an electronic diary to record neuropathic pain. PLoS One. 2007; 2(6):e551. PMC: 1919427. DOI: 10.1371/journal.pone.0000551. View

Keswani S, Polley M, Pardo C, Griffin J, McArthur J, Hoke A . Schwann cell chemokine receptors mediate HIV-1 gp120 toxicity to sensory neurons. Ann Neurol. 2003; 54(3):287-96. DOI: 10.1002/ana.10645. View

Simpson D, Olney R, McArthur J, Khan A, Godbold J . A placebo-controlled trial of lamotrigine for painful HIV-associated neuropathy. Neurology. 2000; 54(11):2115-9. DOI: 10.1212/wnl.54.11.2115. View

Brown S, Simpson D, Moyle G, Brew B, Schifitto G, Larbalestier N . NGX-4010, a capsaicin 8% patch, for the treatment of painful HIV-associated distal sensory polyneuropathy: integrated analysis of two phase III, randomized, controlled trials. AIDS Res Ther. 2013; 10(1):5. PMC: 3610248. DOI: 10.1186/1742-6405-10-5. View

Valcour V, Yeh T, Bartt R, Clifford D, Gerschenson M, Evans S . Acetyl-l-carnitine and nucleoside reverse transcriptase inhibitor-associated neuropathy in HIV infection. HIV Med. 2009; 10(2):103-10. PMC: 2653263. DOI: 10.1111/j.1468-1293.2008.00658.x. View

Simpson D, Brown S, Tobias J . Controlled trial of high-concentration capsaicin patch for treatment of painful HIV neuropathy. Neurology. 2008; 70(24):2305-13. DOI: 10.1212/01.wnl.0000314647.35825.9c. View

Hahn K, Arendt G, Braun J, Von Giesen H, Husstedt I, Maschke M . A placebo-controlled trial of gabapentin for painful HIV-associated sensory neuropathies. J Neurol. 2004; 251(10):1260-6. DOI: 10.1007/s00415-004-0529-6. View

Chen H, Clifford D, Deng L, Wu K, Lee A, Bosch R . Peripheral neuropathy in ART-experienced patients: prevalence and risk factors. J Neurovirol. 2013; 19(6):557-64. PMC: 3965352. DOI: 10.1007/s13365-013-0216-4. View

Simpson D, Tagliati M . Nucleoside analogue-associated peripheral neuropathy in human immunodeficiency virus infection. J Acquir Immune Defic Syndr Hum Retrovirol. 1995; 9(2):153-61. View

10.

Sandoval R, Roddey T, Giordano T, Mitchell K, Kelley C . Randomized Trial of Lower Extremity Splinting to Manage Neuropathic Pain and Sleep Disturbances in People Living with HIV/AIDS. J Int Assoc Provid AIDS Care. 2014; 15(3):240-7. DOI: 10.1177/2325957413511112. View

11.

Estanislao L, Morgello S, Simpson D . Peripheral neuropathies associated with HIV and hepatitis C co-infection: a review. AIDS. 2005; 19 Suppl 3:S135-9. DOI: 10.1097/01.aids.0000192082.41561.49. View

12.

Skopelitis E, Aroni K, Kontos A, Konstantinou K, Kokotis P, Karandreas N . Early detection of subclinical HIV sensory polyneuropathy using intraepidermal nerve fibre density quantification: association with HIV stage and surrogate markers. Int J STD AIDS. 2007; 18(12):856-60. DOI: 10.1258/095646207782717054. View

13.

Lehmann H, Chen W, Borzan J, Mankowski J, Hoke A . Mitochondrial dysfunction in distal axons contributes to human immunodeficiency virus sensory neuropathy. Ann Neurol. 2011; 69(1):100-10. PMC: 3051401. DOI: 10.1002/ana.22150. View

14.

Estanislao L, Carter K, Mcarthur J, Olney R, Simpson D . A randomized controlled trial of 5% lidocaine gel for HIV-associated distal symmetric polyneuropathy. J Acquir Immune Defic Syndr. 2004; 37(5):1584-6. DOI: 10.1097/00126334-200412150-00010. View

15.

Gilron I, Bailey J, Tu D, Holden R, Weaver D, Houlden R . Morphine, gabapentin, or their combination for neuropathic pain. N Engl J Med. 2005; 352(13):1324-34. DOI: 10.1056/NEJMoa042580. View

16.

Harrison T, Miyahara S, Lee A, Evans S, Bastow B, Simpson D . Experience and challenges presented by a multicenter crossover study of combination analgesic therapy for the treatment of painful HIV-associated polyneuropathies. Pain Med. 2013; 14(7):1039-47. PMC: 4207215. DOI: 10.1111/pme.12084. View

17.

Shlay J, Chaloner K, Max M, Flaws B, Reichelderfer P, Wentworth D . Acupuncture and amitriptyline for pain due to HIV-related peripheral neuropathy: a randomized controlled trial. Terry Beirn Community Programs for Clinical Research on AIDS. JAMA. 1998; 280(18):1590-5. DOI: 10.1001/jama.280.18.1590. View

18.

Robinson-Papp J, Gonzalez-Duarte A, Simpson D, Rivera-Mindt M, Morgello S . The roles of ethnicity and antiretrovirals in HIV-associated polyneuropathy: a pilot study. J Acquir Immune Defic Syndr. 2009; 51(5):569-73. PMC: 2792902. DOI: 10.1097/QAI.0b013e3181adcefa. View

19.

Morgello S, Estanislao L, Simpson D, Geraci A, DiRocco A, Gerits P . HIV-associated distal sensory polyneuropathy in the era of highly active antiretroviral therapy: the Manhattan HIV Brain Bank. Arch Neurol. 2004; 61(4):546-51. DOI: 10.1001/archneur.61.4.546. View

20.

Kieburtz K, Simpson D, Yiannoutsos C, Max M, HALL C, Ellis R . A randomized trial of amitriptyline and mexiletine for painful neuropathy in HIV infection. AIDS Clinical Trial Group 242 Protocol Team. Neurology. 1998; 51(6):1682-8. DOI: 10.1212/wnl.51.6.1682. View