Peripheral Neuropathy and HIV/AIDS

Table of Contents

• What Is Peripheral Neuropathy?
• What Causes PN?
• Who Is at Risk of Developing PN?
• How Do You Know if You Have PN?
• PN Treatments
• AIMS for PN

What Is Peripheral Neuropathy?

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.

The most common peripheral neuropathy is called distal symmetric polyneuropathy (DSP), which affects over 20 million Americans. This is what most HIV+ people 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, 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, depressed, and even suicidal.

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)
• Alcoholism
• Vitamin B12 deficiency
• Neurotoxic drugs (see below)

Neurotoxic drugs include many that are 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:"

• 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)
• Pacerone or Cordarone (amiodarone)
• Atromid (clofibrate)
• Dilantin (phenytoin)
• Antabuse (disulfiram, esperal)
• Aczone (dapsone)
• Indomethacin
• Chloroquine
• Certain cancer chemotherapy drugs (e.g., vincristine)