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Peripheral Neuropathy and HIV/AIDS

February 13, 2017

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Table of Contents

What Is Peripheral Neuropathy (PN)?

Many people living with HIV (HIV+) develop problems that involve the nervous system. The nervous system controls thinking, movement, sensations, and feelings.

There are two parts of the nervous system: the brain and spinal cord (central nervous system) and the peripheral nerves (peripheral nervous system). The peripheral nerves run throughout the body like webbing, connecting all the parts of the body to the brain and spinal cord. Any disorder or problem involving damage to the peripheral nerves is called peripheral neuropathy or PN.

Peripheral neuropathy affects over 20 million Americans. The most common form damages not just one nerve (mononeuropathy), but several nerves. This is called polyneuropathy, and is what most people living with HIV are talking about when they say they have neuropathy. Most health care providers know it as a "sock and glove" nerve problem, because the areas most affected are where you wear your socks and gloves.

What Causes PN?

The causes of PN are still unknown. Researchers suspect that either HIV, and/or drugs that are toxic to the nervous system (neurotoxic drugs), or a combination of both may cause damage to the peripheral nerves.

PN happens when the nerves between the feet and/or hands and the spinal cord become damaged. Like frayed wires that can spark or misfire, these damaged nerves do not send their electrical signals properly. As a result, PN can cause feelings of numbness, tingling, burning, itching, or shooting pain. Some people with PN describe their pain as "holding a lit match to my feet," or "walking on broken glass." This chronic (long-lasting) pain can lead those who suffer to become isolated and depressed.


Who Is at Risk of Developing PN?

There are certain risk factors for PN:

  • Low CD4 cell count
  • Older age (greater than 50)
  • Medical conditions (for example, diabetes)
  • Alcohol abuse
  • Vitamin B12 deficiency
  • Diabetes
  • Neurotoxic drugs (see below)

Neurotoxic drugs include many that have been used more commonly in the past to treat HIV or HIV-related conditions. The most familiar are the HIV drugs commonly called the "d-drugs." These d-drugs are rarely used anymore because they are so often toxic to the nervous system:

  • ddI (didanosine,Videx)
  • d4T (stavudine, Zerit)
  • ddC (zalcitibine, Hivid)

Other neurotoxic drugs include:

  • Hydoxyurea
  • INH (isonizaid)
  • Myambutol (ethambutol)
  • Flagyl (metronidazole)
  • Macrobid or Macrodantin (nitrofurantoin)
  • Cipro (ciprofloxacin)
  • Dilantin (phenytoin)
  • Antabuse (disulfiram, esperal)
  • Indomethacin
  • Chloroquine
  • Certain cancer chemotherapy drugs (e.g., vincristine)
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This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.


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