Causes of peripheral neuropathy in HIV patients
Damaged nerve fibers can lead to a loss of sensation or weakness in the arms, legs, hands and feet. The virus infects the nerve cells leading to cell death. This often results in damage to the long myelinated fibers followed by smaller unmyelinated fibers. As cell bodies remain unaffected, neurons continue to produce pain transmitters that remain intact.
HIV-induced peripheral neuropathy, aka “antiretroviral toxic neuropathy,” makes up about 2% of those inflicted with peripheral neuropathy in general. Antiretroviral toxic neuropathy is caused by the toxic effects of highly active antiretroviral therapy (HAART) on the peripheral nervous system.
Recognizing symptoms of HIV-associated neuropathy
Antiretroviral toxic neuropathy comes with several symptoms that include numbness and tingling in the hands, feet, legs, or arms, shooting pains through any of these areas, as well as an overall weakness. Patients have described a sensation of pins and needles in the limbs, burning or lancinating pain, itching, sensitivity to touch, muscular atrophy, swelling or inflammation.
Symptoms include:
- Numbness or tingling in hands and/or feet
- Sharp shooting pain, numbness, or burning in legs and/or feet
- Muscle weakness in one or both extremities
- Loss of balance and coordination, particularly when walking up stairs or turning corners
- Weakening of handgrip strength
These symptoms often come and go to varying degrees. They may be constant at times but are typically episodic — coming on suddenly, lasting for a few minutes or hours, then subsiding.
Effective treatment options for HIV-related peripheral neuropathy
Several treatments have been explored over the years to help those who suffer from HIV-induced peripheral neuropathy. Treatments range from anti-seizure drugs to chemotherapy agents. Anti-seizure medications, antidepressants, or analgesics, including opiate drugs, can all be used to treat neuropathic pain caused by HIV polyneuropathy.
The best treatment is usually symptomatic relief provided by medications that have analgesic, anticonvulsant, antidepressant and/or antiarrhythmic properties.
We will soon recruit participants for a clinical study to treat HIV-associated distal sensory polyneuropathy in patients with HIV.
Conclusion
HIV-induced peripheral neuropathy is one of the most common forms of peripheral neuropathy associated with human immunodeficiency virus, often resulting in pain or numbness in the feet or hands. There are many potential factors causing this form of neuropathy, including chronic immune stimulation from the HIV infection itself, metabolic abnormalities caused by a deranged metabolism stemming from HIV infection, medication side effects, such as antiretrovirals, and traditional drugs used for treating HIV known as antiretroviral therapies.
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Sources
- “HIV Neuropathy”. Johns Hopkins Medicine
- UNAIDS
- “Basic Statistics | HIV Basics | HIV/AIDS”. Centers for Disease Control and Prevention
FAQs
What are the causes of HIV-induced peripheral neuropathy?
Damaged nerve fibers can lead to a loss of sensation or weakness in the arms, legs, hands and feet. The virus infects the nerve cells leading to cell death. This often results in damage to the long myelinated fibers followed by smaller unmyelinated fibers. As cell bodies remain unaffected, neurons continue to produce pain transmitters that remain intact.
HIV-induced peripheral neuropathy, aka “antiretroviral toxic neuropathy,” makes up about 2% of those inflicted with peripheral neuropathy in general. Antiretroviral toxic neuropathy is caused by the toxic effects of highly active antiretroviral therapy (HAART) on the peripheral nervous system.
What are the symptoms of HIV-induced peripheral neuropathy?
Antiretroviral toxic neuropathy comes with several symptoms that include numbness and tingling in the hands, feet, legs, or arms, shooting pains through any of these areas, as well as an overall weakness. Patients have described a sensation of pins and needles in the limbs, burning or lancinating pain, itching, sensitivity to touch, muscular atrophy, swelling or inflammation.
Symptoms include:
- Numbness or tingling in hands and/or feet
- Sharp shooting pain, numbness, or burning in legs and/or feet
- Muscle weakness in one or both extremities
- Loss of balance and coordination, particularly when walking up stairs or turning corners
- Weakening of handgrip strength
These symptoms often come and go to varying degrees. They may be constant at times but are typically episodic — coming on suddenly, lasting for a few minutes or hours, then subsiding.
What are the treatments for HIV-induced peripheral neuropathy?
Several treatments have been explored over the years to help those who suffer from HIV-induced peripheral neuropathy. Treatments range from anti-seizure drugs to chemotherapy agents. Anti-seizure medications, antidepressants, or analgesics, including opiate drugs, can all be used to treat neuropathic pain caused by HIV polyneuropathy.
The best treatment is usually symptomatic relief provided by medications that have analgesic, anticonvulsant, antidepressant, and/or antiarrhythmic properties.
