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Peripheral neuropathies associated with human immunodeficiency virus infection
1Department of Neurology, Hahnemann University Hospital, Philadelphia, PA 19102.
Annals of Neurology
|January 1, 1988
Summary
Peripheral neuropathies are common in human immunodeficiency virus (HIV) infection, presenting differently in early stages versus acquired immunodeficiency syndrome (AIDS). Understanding these patterns is crucial for patient management and prognosis.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Peripheral neuropathies are common neurological complications across all stages of human immunodeficiency virus (HIV) infection.
- Neuropathies manifest differently in acute HIV infection, asymptomatic HIV infection, acquired immunodeficiency syndrome (AIDS)-related complex, and AIDS itself.
- Neuropathy is a frequent manifestation in AIDS-related complex, affecting up to 20% of patients.
Purpose of the Study:
- To review the various types of peripheral neuropathies associated with HIV infection.
- To discuss the clinical presentation, potential pathogenesis, and prognosis of HIV-related neuropathies.
- To differentiate neuropathies seen in AIDS-related complex from those associated with advanced AIDS.
Main Methods:
- Review of existing literature on peripheral neuropathies in HIV-infected individuals.
- Categorization of neuropathies based on stage of HIV infection and clinical presentation.
- Analysis of reported frequencies, pathogenesis, and treatment outcomes.
Main Results:
- Acute HIV infection can cause acute inflammatory demyelinating polyneuropathy, sensory ganglioneuritis, and cranial nerve palsies.
- AIDS-related complex frequently presents with acute/chronic inflammatory demyelinating polyneuropathy (38%) and mononeuropathy multiplex (29%), often with good prognosis.
- Neuropathy in AIDS is typically a distal symmetrical polyneuropathy (72%), with inflammatory types being rare; pathogenesis may be infectious, toxic, or nutritional.
Conclusions:
- Peripheral neuropathies are diverse manifestations of HIV infection, requiring careful diagnosis and management.
- The type of neuropathy often correlates with the stage of HIV infection and may have different underlying causes.
- While some HIV-associated neuropathies have favorable prognoses, others, particularly in advanced AIDS, require further investigation into their pathogenesis and treatment.
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