HIV/AIDS & Neuropathy

HIV/AIDS & Neuropathy

Painful neuropathy, also called peripheral neuropathy or painful peripheral neuropathy, is a common complication of HIV infection. It is a condition that is related to damaged peripheral nerves and can cause pain ranging from minor discomfort to disabling weakness. For a complete description of neuropathy, please visit neurologychannel.com.

The AIDS virus, as well as many of the HIV-associated infections (e.g., herpes, cytomegalovirus [CMV]), can cause peripheral neuropathy. Fortunately, the use of antiretroviral therapy has greatly reduced the incidence of painful neuropathy resulting from HIV or HIV-associated conditions. However, neuropathy remains an HIV-related problem, as it is a common side effect of antiretroviral medication, especially stavudine, didanosine, and zalcitabine.

In some cases, changing antiretrovirals can help relieve neuropathy or the condition can be treated medically, depending on the exact cause. Antidepressants (e.g., amitryptaline, desipramine, doxepin) have proven to be effective, as have several anti-seizure agents (e.g., gabapentin, lamotrigene, carbamazepine, valproic acid). Anti-seizure drugs usually have fewer side effects than antidepressants.

In addition to changing antiretrovirals and/or prescribing medication, there are a number of other ways to relieve neuropathy pain, including the following:

• Do not wear tight shoe or socks.
• Do not walk or stand for too long.
• Soak the feet or hands in cold water for 15 minutes twice a day, and use a moisturizer.
• Hand and foot massage can increase circulation and help relieve pain.
• Exercise to increase circulation to the hands and feet.

HIV/AIDS & Dementia

HIV infection can lead to AIDS-related dementia. Fortunately, this condition is much less common since the advent of potent combination antiretroviral therapy. When AIDS dementia does develop, the complex usually involves cognitive (e.g., inability to pay attention, loss of memory), motor (e.g., clumsiness, slowed movements), and behavioral (e.g., changed personality) dysfunction and typically develops in the later stages of HIV infection. Most HIV patients who are not on antiretroviral therapy experience dementia at some point during the illness.

There is no specific treatment for AIDS dementia, other than antiretroviral therapy. Patients with dementia who do not respond to antiretroviral therapy may benefit from treatment with tranquilizers such as haloperidol, respirdal, or zyprexa. These patients should seek treatment from a neurologist or psychiatrist who is experienced in treating AIDS-related dementia.