Infective neuropathies

Infective neuropathies encompass neuropathies that are among the most common in the world. Retroviral infection, which includes infection with the human immunodeficiency virus, has now spread worldwide. This virus is responsible for a number of disabling peripheral neuropathies, either from the immune reaction that follows penetration of the virus into nervous system of the host, or by opportunistic infection secondary to the major cellular immunodeficit induced by gradual destruction of lymphocytes bearing the CD4 antigen on their surface. In the other class of retroviruses, human T lymphotrophic viruses (HTLV), which are responsible for the HTLV-I-associated myelopathy or tropical spastic paraparesis, peripheral nerve involvement and inflammatory myopathy are less common and milder than in HIV infection. Leprosy continues to pose problems concerning the understanding of the immune mechanisms that lead to the various patterns of nerve lesions encountered in this condition. Chagas' disease, which is due to infection with Trypanosoma cruzi, affects more than 15 million people in Latin America. It is accompanied by mostly subclinical peripheral nerve involvement and by cardiac manifestations from lesions of the autonomic nervous system and cardiac muscle.