I am 43 y.o. white gay man first diagnosed with HIV in July of 1987.Recently, I have been diagnosed with carpal tunnel syndrome, which causes me both pain and numbness in both hands. I also have neuropathy in my hands and my feet. Currently, I am taking only D4T and 3TC, since I have not been able to tolerate any of the proteases. My last viral load was 31000 and my CD4 was 400. The surgeon who will be doing the carpal tunnel surgery has no experience with HIV patients and is unsure if the surgery will be successful if HIV prevents my nerves from regenerating some. What do you think? Surgery or not?

My experience is that Carpal tunnel surgery works as well in people with HIV as in those without. It has a high chance of fixing the carpal tunnel induced symptoms, but won't do anything for the neuropathy symptoms.

How do you tell them apart? It might be difficult. Carpal tunnel affects the median nerve, so the numbness and pain are in the thumb, index and middle finger, not the 4th and 5th finger. There are some maneuvers that the surgeon does in the office which can make carpal tunnel symptoms worse. Those are the ones likely to get better. Another clue; If using a splint helps, and if your symptoms get better if you lay off typing, sewing or whatever is making the carpal tunnel worse, surgery is likely to help. Sometimes a nerve conduction study can help sort it out.

Bottom line, if it is pretty clear that some of the symptoms are carpal tunnel, the surgery will probably help those. Consider going for it. ATP