hi docors- i am a 46 yr. old male, poz for about 15 yrs. CD4 of 275, and low viral load. iwas recently switched from epivir/kaletra/sustiva to epivir/viramune/viread. Lately i've been suffering with tingling/burning sensations in my feet and legs which seem to be worse at night. It is very dabilitating, and i am very fatigued and depressed. Can any of these drugs cause neuropathy? can you offer any suggestions or help? thank you.

The drugs you were on previously and your current ones are not usually linked to peripheral neuropathy but can rarely cause or aggravate it. 3TC would be the most likely aggravating drug. Switching to abacavir or AZT might be helpful if the neuropathy is drug related. HIV and some vitamin deficiencies (B12, B6) and some other infections (i.e. syphilis) can also cause it. A full examination is often helpful in sorting out (sometimes seeing a neurologist or a pain specialist is worthwhile). Acupuncture and massage are sometimes useful. In the US Neurontin is popular for treating the neuropathy. Amitryptiline is also used with some benefit. A discussion of some alternative therapies can be found in Jon Kaiser's book Healing HIV or at the website www.daair.org KH