[Peripheral nerve diseases and myopathies associated with HIV infection]

Diseases of the peripheral nervous system occur in up to 50% of persons infected with human immunodeficiency virus (HIV). In early stages of the infection, Guillain-Barré syndrome or a spontaneously remitting mononeuropathy can occur. The most frequent occurrence is distal symmetrical polyneuropathy associated with HIV, which can only be treated symptomatically. The most important differential diagnosis is a drug-induced polyneuropathy under antiretroviral therapy with the nucleoside analogues DDI, DDC, or D4T. Chronic inflammatory demyelinating polyneuropathy is less common and can be treated with immunoglobulins or corticosteroids. Very rare are steroid-responsive neuropathies with necrotizing vasculitis or in diffuse infiltrative lymphocytosis syndrome (DILS). In the AIDS stage, polyradiculitis can occur due to opportunistic infections--most often with cytomegalovirus (CMV) or M. tuberculosis--or polyradiculopathies due to lymphomatous meningiosis. Mononeuritis multiplex is rarely seen in disseminated CMV infection. Myopathies can occur in all stages of HIV infection; their frequency is about 1%. Primary polymyositis associated with HIV, which can be treated with corticosteroids or immunoglobulin, must be distinguished from myopathy induced by azidothymidine. Other forms of myopathy are very rare.