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Can neuropathy occur with undetectable viral load?
Mar 4, 2014

Some months ago i started feeling very uncomfortable stinging and burning in my skin over large parts of my body. It had started as an unusual warmth in my feet but that has largely gone away. Now it is just about everywhere else. I saw a neurologist at Mt. Sinai in NYC. He tested for peripheral neuropathy, small fiber neuropathy and other neurological disorders and says nothing shows up. My viral load has been undetectable for several year with a cd4 count near 500. I have taken Viread, Abacavir and Issentress for several years. Do my symptoms sound like some kind of neuropathy? A drug toxicity reaction? Or possibly something altogether different? I am desperate for help with this. Thank you.

Response from Dr. Henry

Drug related neuropathy usually first involves the longer nerves so first symptoms usually seen in toes/feet and most often in a symmetric manner.HIV drug or HIV related neuropathy is more often seen in persons with lower CD4 counts (not an issue in your case) There can be idiosyncratic/rare drug side effects that that have atypical features. Your specific HIV regimen has not commonly been linked to significant risk for neuropathy. If no explanation can be found then consideration is sometimes given to reviewed all meds and then discuss a planned drug substitution approach to sort out if one of the drugs you are taking is a main factor. Hormone problems, vitamin deficiencies, occult skin problems, and other non-HIV conditions can cause some unusual symptoms such as you describe.KH



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