Skip to main content

Peripheral Neuropathy Associated With Nucleoside Reverse Transcriptase Inhibitor Therapy

  • Chapter
Reverse Transcriptase Inhibitors in HIV/AIDS Therapy

Part of the book series: Infectious Disease ((ID))

  • 737 Accesses

Abstract

Peripheral neuropathies are the most common neurological syndromes associated with HIV infection. The spectrum of neuropathic syndromes is broad (xi238-1|Table 1), and neuropathies may be encountered during any stage of the infection. Some disorders of the peripheral nerves in patients with HIV infection are presumed to be caused by pathological factors resulting from the virus itself, whereas others may result from responses of a competent immune system to viral antigens, opportunistic processes unleashed when immune deficiency has occurred, or as adverse effects of therapies for AIDS-related diseases. To provide a context for understanding the toxic neuropathies, these other HIV-related neuropathies are briefly described in this first section.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Griffin JW, Crawford To, McArthur JC. Peripheral Neuropathies Associated With HIV Infection. In: Gendelman HE, Lipton SA, Epstein L, Swindells S, eds. The Neurology of AIDS.New York, NY: Chapman & Hall; 1998:275–291.

    Google Scholar 

  2. Cornblath DR, McArthur JC, Kennedy, PGE, Witte AS, Griffin JW. Inflammatory demyelinating peripheral neuropathies associated with human T-cell lymphotropic virus type III infection. Ann Neurol 1987;21:32–40.

    Article  PubMed  CAS  Google Scholar 

  3. de la Monte SM, Gabuzda DH, Ho DD, et al. Peripheral neuropathy in the acquired immunodeficiency syndrome. Ann Neurol 1988;23:485–492.

    Article  PubMed  Google Scholar 

  4. Lipkin WI, Parry G, Kiprov D, Abrams D. Inflammatory neuropathy in homosexual men with lymphadenopathy. Neurology 1985;35:1479–1483.

    PubMed  CAS  Google Scholar 

  5. Said G, Lacroix C, Chemouilli P, et al. Cytomegalovirus neuropathy in acquired immunodeficiency syndrome: a clinical and pathological study. Ann Neurol 1991;29:139–146.

    Article  PubMed  CAS  Google Scholar 

  6. Eidelberg D, Sotrel A, Vogel H, et al. Progressive polyradiculopathy in acquired immune deficiency syndrome. Neurology 1986;36:912–916.

    PubMed  CAS  Google Scholar 

  7. Miller RG, Storey JR, Greco CM. Ganciclovir in the treatment of progressive AIDS related polyradiculopathy. Neurology 1990;40:569–574.

    PubMed  CAS  Google Scholar 

  8. Cohen BA, McArthur JC, Grohman S, Patterson B, Glass JD. Neurologic prognosis of cytomegalovirus polyradiculomyelopathy in AIDS. Neurology 1993;43:493–499.

    PubMed  CAS  Google Scholar 

  9. Clifford DB, Buller RS, Mohammed S, Robison L, Storch GA. Use of polymerase chain reaction to demonstrate cytomegalovirus DNA in CSF of patients with human immunodeficiency virus infection. Neurology 1993;43:75–79.

    PubMed  CAS  Google Scholar 

  10. Itescu S, Brancato LJ, Buxbaum J, et al. A diffuse infiltrative CD8 lymphotosis syndrome in human immunodeficiency virus (HIV) infection: a host immune response associated with HLA-DR5. Ann Intern Med 1990;112:3–10.

    PubMed  CAS  Google Scholar 

  11. Gherardi RK, Chretien F, Delrau-Larue MH, et al. Neuropathy in diffuse infiltrative lymphocytosis syndrome. Neurology 1998;50:1041–1044.

    PubMed  CAS  Google Scholar 

  12. Pardo CA, McArthur JC, Griffin JW. HIV neuropatsshy: insights in the pathology of HIV peripheral nerve disease. J Peripher Nerv Syst 2001;6:21–27.

    Article  PubMed  CAS  Google Scholar 

  13. So YT, Holtzman DM, Abrams DI, et al. Peripheral neuropathy associated with acquired immunodeficiency syndrome. Prevalence and clinical features from a population based survey. Arch Neurol 1988;45:945–948.

    PubMed  CAS  Google Scholar 

  14. Tagliati M, Grinnell J, Godbold J, Simpson DM. Peripheral nerve function in HIV infection: clinical, electrophysiological, and laboratory findings. Arch Neurol 1999;56:84–89.

    Google Scholar 

  15. Cornblath DR, McArthur JC. Predominantly sensory neuropathy in patients with AIDS and AIDS-related complex. Neurology 1988;38:794–796.

    PubMed  CAS  Google Scholar 

  16. Leger JM, Bouche P, Bolgert F, et al. The spectrum of polyneuropathies in patients infected with HIV. J Neurol Neurosurg Psychiatry 1989;52:1369–1374.

    Article  PubMed  CAS  Google Scholar 

  17. Fuller GN, Jacobs JM, Guiloff RJ. Nature and incidence of peripheral nerve syndromes in HIV infection. J Neurol Neurosurg Psychiatry 1993;56:372–381.

    Google Scholar 

  18. Simpson DM, Tagliati M. Nucleoside analogue-associated peripheral neuropathy in human immunodeficiency virus infection. J Acquir Immune Defic Syndr 1995;9:153–161.

    Google Scholar 

  19. Winer JB, Bang B, Clarke JR, et al. A study of neuropathy in HIV infection. Q J Med 1992;83:473–488.

    PubMed  CAS  Google Scholar 

  20. Bouhassira D, Attal N, Willer J-C, Brasseur L. Painful and painless peripheral sensory neuropathies due to HIV infection: a comparison using quantitative sensory evaluation. Pain 1999;80:265–272.

    Article  PubMed  CAS  Google Scholar 

  21. Hermann DN Griffin JW Hauer P Cornblath DR McArthur JC. Epidermal nerve fiber density and sural nerve morphometry in peripheral neuropathies. Neurology 1999;53:1634–1640

    Google Scholar 

  22. McCarthy BG, Hsieh S-T, Stocks MA, et al. Cutaneous innervation in sensory neuropathies: evaluation by skin biopsy. Neurology 1995;45:1848–1855.

    PubMed  CAS  Google Scholar 

  23. Polydefkis M, Yiannoutsos CT, Cohen BA, et al. Reduced intraepidermal nerve fiber density in HIV-associated sensory neuropathy. Neurology 2002;58: 115–119.

    Article  PubMed  CAS  Google Scholar 

  24. Chaunu MP, Ratinahirana H, Raphael M, et al. The spectrum of changes on 20 nerve biopsies in patients with HIV infection. Muscle Nerve 1989; 12:452–459.

    Article  PubMed  CAS  Google Scholar 

  25. Childs EA, Lyles RH, Selnes oA, et al. Plasma viral load and CD4 lymphocytes predict HIV-associated dementia and sensory neuropathy. Neurology 1999;52: 607–613.

    PubMed  CAS  Google Scholar 

  26. Simpson DM, Haidich AB, Schiffito G, et al. Severity of HIV-associated neuropathy is associated with plasma HIV-1 RNA levels. AIDS 2002; 16:407–412.

    Article  PubMed  CAS  Google Scholar 

  27. Sactor NC, Lyles RH, Scholasky RL, et al. Combination antiretroviral therapy improves psychomotor speed performance in HIV-seropositive homosexual men. Multicenter AIDS Cohort Study (MACS). Neurology 1999;52:1640–1647.

    Google Scholar 

  28. Maschke M, Kastrup o, Esser S, et al. Incidence and prevalence of neurological disorders associated with HIV since the introduction of highly active antiretroviral therapy (HAART). J Neurol Neurosurg and Psychiatry 2000;69:376–380.

    Article  CAS  Google Scholar 

  29. Moyle GJ, Sadler M. Peripheralneuropathy with nucleoside antiretrovirals: risk factors, incidence and management. Drug Saf 1998; 19:481–494.

    Article  PubMed  CAS  Google Scholar 

  30. Dubinsky RM, Yarchoan R, Dalakas M, Broder S. Reversible axonal neuropathy from the treatment of AIDS and related disorders with 2′3′dideoxycytidine (ddC). Muscle Nerve 1989; 12:856–860.

    Article  PubMed  CAS  Google Scholar 

  31. Kieburtz KD, Seidlin M, Lambert JS, et al. Extended follow up of peripheral neuropathy in patients with AIDS and ARC treated with ddI. J Acquir Immune Defic Syndr 1992;5:60–64.

    PubMed  CAS  Google Scholar 

  32. Berger AR, Arezzo JC, Schaumburg HH, et al. 2′3′-dideoxycytidine (ddC) toxic neuropathy: a study of 52 patients. Neurology 1993;43:358–362.

    PubMed  CAS  Google Scholar 

  33. Moyle G. Clinical manifestations and management of antiretroviral nucleoside analogue-related mitochondrial toxicity. Clin Ther2000;22:911–936.

    Article  PubMed  CAS  Google Scholar 

  34. Yarchoan R, Perno CF, Thomas RV, et al. Phase I studies of 2′3′dideoxycytidine in severe human immunodeficiency virus infection as a single agent and alternating with ZDV (AZT). Lancet 1988; 1:76–81.

    Article  PubMed  CAS  Google Scholar 

  35. Skowron G. Biologic effects and safety of stavudine: overview of phase I and II clinical trials. J Infect Dis 1995;171(Suppl 2):S113-S117.

    Google Scholar 

  36. Fichtenbaum CJ, Clifford DB, Powderly WG. Risk factors for dideoxynucleoside induced toxic neuropathy in patients with HIV infection. J Acquir Immune Defic Syndr Hum Retrovirol 1995; 10:169–174.

    PubMed  CAS  Google Scholar 

  37. Blum A, Dal Pan GJ, Feinberg J, et al. Low-dose zalcitabine-related toxic neuropathy: frequency, natural history and risk factors. Neurology 1996;46:999–1003.

    PubMed  CAS  Google Scholar 

  38. Merigan TC, Skowron G, Bozette SA, et al. Circulating P24 antigen levels and responses to dideoxycytidien in human immunodeficiency virus (HIV) infections. Ann Intern Med 1989; 110:189–194.

    PubMed  CAS  Google Scholar 

  39. Fischl MA, olson RM, Follansbee SE, et al. Zalcitabine compared with zidovu dine in patients with advanced HIV-1 infection who received previous ZDV ther apy. Ann Intern Med 1993; 118:762–769.

    PubMed  CAS  Google Scholar 

  40. Skowron G, Bozette SA, Lim L, et al. Alternating and intermittent regimens of ZDV and dideoxycytidine in patients with AIDS or AIDS-related complex. Ann Intern Med 1993;118:321–330.

    PubMed  CAS  Google Scholar 

  41. Abrams DI, Goldman AI, Laurer C, et al. A comparative trial of ddI or ddC after treatment with ZDV in patients with HIV infection. N Engl J Med 1994;330: 657–662.

    Article  PubMed  CAS  Google Scholar 

  42. Fischl MA, Stanley K, Collier AC, et al. Combination and monotherapy with zidovudine and zalcitabine in patients with advanced HIV disease. Ann Intern Med 1995; 122:24–32.

    PubMed  CAS  Google Scholar 

  43. Lambert JS, Seidlin M, Reichman RC, et al. 2′3′ Dideoxyinosine (ddI) in patients with the acquired immune deficiency syndrome or AIDS-related complex: a phase I trial. N Engl J Med 1990;322:1333–1340.

    Article  PubMed  CAS  Google Scholar 

  44. Lambert JS, Seidlin M, Valentine FT, Reichman RC, Dolin R. Didanosine: long term follow up of patients in a phase I study. Clin Infect Dis 1993;16(Suppl 1): S40–S45.

    PubMed  Google Scholar 

  45. Kahn Jo, Lagakos SW, Richman DD, et al. A controlled trial comparing continued zidovudine with didanosine in human immunodeficiency virus infection. N Engl J Med 1992;327:581–587.

    Article  PubMed  CAS  Google Scholar 

  46. Yarchoan R, Pluda% JM, Thomas RV, et al. Long term toxicity/activity profile of 2′3′ dideoxyinosine in AIDS or AIDS-related complex. Lancet 1990;336:526–529.

    Article  PubMed  CAS  Google Scholar 

  47. Nguyen B-Y, Yarchoan R, Wyvill K, et al. Five year follow up of a phase I study of didanosine in patients with advanced human immunodeficiency virus infection. J Infect Dis 1995;171:1180–1189.

    PubMed  CAS  Google Scholar 

  48. Cooley TP, Kurches LM, Saunders CA, et al. 2′3′ dideoxyinosine (ddI) in patients with the acquired immune deficiency syndrome or AIDS-related complex. N Engl JMed 1990;322:1340–1345.

    CAS  Google Scholar 

  49. Alpha International Coordinating Committee. European/Australian randomized double-blind trial of 2 doses of didanosine in zidovudine intolerant patients with symptomatic HIV disease. Acquir Immune Defic Syndr 1996; 10:867–880.

    Google Scholar 

  50. Browne MJ, Mayer KH, Chafee SBD, et al. 2′3′didehydro-3′-deoxythymidine (d4T) in patients with AIDS or ARC: a phase I trial. J Infect Dis 1993;167:21–29.

    PubMed  CAS  Google Scholar 

  51. Spruance SL Pavia AT Mellors JW et al. Clinical efficacy of monotherapy with stavudine compared with zidovudine in HIV-infected zidovudine experienced patients: a randomized double-blind controlled trial. Ann Intern Med 1997; 126: 355–363]

    Google Scholar 

  52. Varma A, Schein RMH, Jayaweera DT, Kett DH. Fulminant neuropathy and lactic acidosis associated with nucleoside analogue therapy. Neurology] 1999;53: 1365–13

    Google Scholar 

  53. Falco V, Rodriguez D, Ribera E, et al. Severe nucleoside-associated lactic acidosis in human immunodeficiency virus-infected patients: report of 12 cases and review of the literature. Clin Infect Dis 2002;34:838–846.

    Article  PubMed  Google Scholar 

  54. Marcus K, Truffa M, Boxwell D, Toerner J. Recently identified adverse events secondary to NRTI therapy in HIV-infected individuals: cases from the FDA’s adverse event reporting system (AERS) [abstract LB14]. 9th Conference on Retroviruses and opportunistic Infections; Seattle, WA; Feb 24–28, 2002.

    Google Scholar 

  55. LaLacheur S, Simon GL. Exacerbation of dideoxycytidine-induced neuropathy with dideoxyinosine. J Acquir Immune Defic Syndr 1991;4:538–539.

    Google Scholar 

  56. Reynes J, Denisi R, Massip P, et al. once-daily administration of didanosine in combination with stavudine in antiretroviral-naive patients. J Acquir Immune Defic Syndr Hum Retrovirol 1999;22:103–105.

    CAS  Google Scholar 

  57. Pollard RB, Peterson D, Hardy D, et al. Safety and efficacy of combined didano sine and stavudine in HIV-infected individuals with CD4 counts of 200 to 500 cells/mm3. J Acquir Immune Defic Syndr Hum Retrovirol 1999;22:39–48.

    CAS  Google Scholar 

  58. Rutschmann oT, Vernazza PL, Bucher HC, et al. Long term hydroxyurea in com bination with didanosine and stavudine for the treatment of HIV-1 infection. AIDS 2000;14:2145–2151.

    Article  PubMed  CAS  Google Scholar 

  59. Moore RD, Wong W-ME, Keruly JC, McArthur JC. Incidence of neuropathy in HIV-infected patients on monotherapy versus those on combination therapy with didanosine, stavudine and hydroxyurea. AIDS 2000; 14:273–278.

    Article  PubMed  CAS  Google Scholar 

  60. Cepeda JA, Wilks D. Excess peripheral neuropathy in patients treated with hydroxyurea plus didanosine and stavudine for HIV infection. AIDS 2000; 14: 332–333.

    Article  PubMed  CAS  Google Scholar 

  61. Cupler EJ, Dalakas MC. Exacerbation of peripheral neuropathy by lamivudine. Lancet 1995;345:460–461.

    Article  PubMed  CAS  Google Scholar 

  62. Lewis W, Dalakas MC. Mitochondrial toxicity of antiviral drugs. Nat Med 1995; 1: 417–422.

    Article  PubMed  CAS  Google Scholar 

  63. Brinkman K, ter Hofstede HJM, Burger DM, et al. Adverse effects of reverse tran scriptase inhibitors: mitochondrial toxicity as common pathway. AIDS 1998;12: 1735–1744.

    Article  PubMed  CAS  Google Scholar 

  64. Kakuda TN. Pharmacology of nucleoside and nucleotide reverse transcriptase inhibitor-induced mitochondrial toxicity. Clin Ther 2000;22:685–708.

    Article  PubMed  CAS  Google Scholar 

  65. Brinkman K, Smeitink JA, Romijn JA, Reiss P. Mitochondrial toxicity induced by nucleoside reverse-transcriptase inhibitors is a key factor in the pathogenesis of antiretroviral-therapy-related lipodystrophy. Lancet 1999;354:1112–1115.

    Article  PubMed  CAS  Google Scholar 

  66. Chen C-H, Vazquez-Padua M, Cheng Y-C. Effect of anti-human immunodeficiency virus nucleoside analogues on mitochondrial DNA and its implication for delayed toxicity. Mol Pharmacol 1991;39:625–628.

    PubMed  CAS  Google Scholar 

  67. Cui L, Locatelli L, Xie M-T, Sommadossi J-P. Effect of nucleoside analogs on neurite regeneration and mitochondrial DNA synthesis in PC-12 cells. J Pharmacol ExpTher 1997;280:1228–1234.

    CAS  Google Scholar 

  68. Keilboutgh SA, Hobbs GA, Simpson MV. Effect of 2′3′ dideoxycytidine on oxida-tive phosphorylation in the PC-12 cell, a neuronal model. Biochem Pharmacol 1997;53:1485–1492.

    Article  Google Scholar 

  69. Anderson TD, Davidovich A, Feldman D, et al. Mitochondrial schwannopathy and peripheral myelinopathy in a rabbit model of dideoxycytidine neurotoxicity. Lab Invest 1994;70:724–739.

    PubMed  CAS  Google Scholar 

  70. Patterson TA, Schmued LC, Sandberg JA, Slikker W Jr. Temporal development of 2′3′ dideoxyinosine (ddI)-induced peripheral myelinopathy. Neurotoxicol Teratol 2000;22:429–434.

    Article  PubMed  CAS  Google Scholar 

  71. Dalakas MC, Semino-Mora C, Leon-Monzon M. Mitochondrial alterations with mitochondrial DNA depletion in the nerves of AIDS patients with peripheral neu ropathy induced by 2′3′-dideoxycytidine (ddC). Lab Invest 2001;81:1537–1544.

    PubMed  CAS  Google Scholar 

  72. Famularo G, Moretti S, Marcillini S, et al. Acetyl-carnitine deficiency in AIDS patients with neurotoxicity on treatment with antiretroviral nucleoside analogues. AIDS 1997; 11:185–190.

    Article  PubMed  CAS  Google Scholar 

  73. Simpson DM, Katzenstein D, Haidich B, et al. Plasma carnitine in HIV-associated neuropathy. Neurology 2001;15:2207–2208.

    CAS  Google Scholar 

  74. Hart AM, Wilson ADH, Montaovani C, et al. Acetyl-L-carnitine: a pathogenesis based treatment for HIV-associated antiretroviral toxic neuropathy. AIDS 2004; 18: 1549–1560.

    Article  PubMed  CAS  Google Scholar 

  75. Scarpini E, Sacilotto G, Baron P, Cusini M, Scarlato G. Effect of acetyl-L-carnitine in the treatment of painful peripheral neuropathies in HIV+ patients. J Peripher Nerv Syst 1997;2:250–252.

    PubMed  CAS  Google Scholar 

  76. World Health organization. Cancer Pain Relief. 2nd ed. Geneva, Switzerland: World Health organization; 1996:15–16.

    Google Scholar 

  77. Simpson DM, McArthur JC, olney R, et al. A multicenter, double-blind, random ized, placebo-controlled evaluation of lamotrigine in adult subjects with painful HIV-associated peripheral neuropathy. Neurology 2002;58(Suppl 3):A407.

    Google Scholar 

  78. Kieburtz K, Simpson D, Yiannoutsos C, et al. A randomized trial of amitriptyline and mexiletine for painful neuropathy in HIV infection. Neurology 1998;51: 1682–1688.

    PubMed  CAS  Google Scholar 

  79. Simpson DM, Katzenstein DA, Hughes MD, et al. Neuromuscular function in HIV infection: analysis of a placebo-controlled combination antiretroviral trial. AIDS 1998; 12:2425–2432.

    Article  PubMed  CAS  Google Scholar 

  80. Marra CM, Boutin P, Collier AC. Screening for distal sensory peripheral neuro pathy in HIV-infected persons in research and clinical settings. Neurology 1998;51:1678–1681.

    PubMed  CAS  Google Scholar 

  81. Schiffito G, McDermott MP, McArthur JC, et al. Incidence of and risk factors for HIV-associated distal sensory polyneuropathy. Neurology 2002;58:1764–1768.

    Google Scholar 

  82. Martin C, Solders G, Sonnerborg A, Hansson P. Antiretroviral therapy may improve sensory function in HIV-infected patients: a pilot study. Neurology 2000;54: 2120–2127.

    PubMed  CAS  Google Scholar 

  83. McArthur JC, Yiannoutsos C, Simpson DM, et al. A phase II trial of nerve growth factor for sensory neuropathy associated with HIV infection. Neurology 2000;54:1080–1088.

    PubMed  CAS  Google Scholar 

  84. Schifitto G, Yiannoutsos C, Simpson DM, et al. Long-term treatment with recom binant nerve growth factor for HIV-associated sensory neuropathy. Neurology 2001;57:1313–1316.

    PubMed  CAS  Google Scholar 

  85. Rosso R, Di Baagio A, Ferrazin A, et al. Fatal lactic acidosis and mimicking Guillain-Barré syndrome in an adolescent with human immunodeficiency virus infection. Ped Infec Dis J 2003;22:668–670.

    Article  Google Scholar 

  86. Shah SS, Rodriguez T, McGowan JP. Miller Fisher variant of Guillain-Barré syn drome associated with lactic acidosis and stavudine therapy. Clin Infect Dis 2003;36:e131–e133.

    Article  PubMed  Google Scholar 

  87. Simpson D, Estanislao L, Evans S, et al. HIV-associated neuromuscular weakness syndrome. AIDS 2004; 18:1403–1412.

    Article  Google Scholar 

  88. Brew B, Tisch S, Law M. Lactate concentrations distinguish between nucleoside neuropathy and HIV neuropathy. AIDS 2003; 17:1094–1096.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Cohen, B.A., Bartt, R. (2006). Peripheral Neuropathy Associated With Nucleoside Reverse Transcriptase Inhibitor Therapy. In: St.Georgiev, V., Skowron, G., Ogden, R., Lange, J.M.A. (eds) Reverse Transcriptase Inhibitors in HIV/AIDS Therapy. Infectious Disease. Humana Press. https://doi.org/10.1007/978-1-59745-085-0_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-59745-085-0_8

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-649-8

  • Online ISBN: 978-1-59745-085-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics