Treatment of human immunodeficiency virus-related polyneuropathy with 3'-azido-2',3'-dideoxythymidine

A 72-year-old woman with human immunodeficiency virus (HIV)-related axonal polyradiculoneuropathy of the lower extremities was treated with 3'-azido-2',3'-dideoxythymidine (AZT), 250 mg every 4 hours. Before therapy she had rapidly progressive weakness in both legs and when treatment began she could move only her toes. Six weeks after therapy, there was mild improvement in her strength, which peaked 2 months later. At her best, she was able to lift her leg 30 degrees off the bed and stand with assistance. Improvement, which was also demonstrated electrophysiologically, was short lived and partially declined when AZT was discontinued. This case demonstrates that some patients with HIV-related axonal neuropathies even in advanced stages can show objective signs of improvement when given AZT. A systematic trial with AZT in the treatment of patients with HIV-related polyneuropathies is therefore warranted.