Neuropathy complication of antiretroviral therapy in HIV/AIDS patients

Winias, Saka; Radithia, Desiana; Ernawati, Diah Savitri

doi:10.1111/odi.13398

Cited by 7 publications

(5 citation statements)

References 25 publications

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“…Indeed, ART has a direct effect on the bone metabolism by exacerbating bone loss (with a reported 2-6% loss in BMD) at the femora, lumbar spine, and hips; which are sites susceptible to fractures [173,179,183]. Lastly, neuropathy may be another potential complication of ART [184,185], which may indirectly impact the skeletal system by leading to conditions such as neuropathic arthropathy (Charcot joint) [186,187].…”

Section: Antiretroviral Therapymentioning

confidence: 99%

How Do Drugs Affect the Skeleton? Implications for Forensic Anthropology

Márquez‐Grant

Baldini

Jeynes

et al. 2022

Biology

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Forensic anthropologists rely on a number of parameters when analyzing human skeletal remains to assist in the identification of the deceased, predominantly age-at-death, sex, stature, ancestry or population affinity, and any unique identifying features. During the examination of human remains, it is important to be aware that the skeletal features considered when applying anthropological methods may be influenced and modified by a number of factors, and particular to this article, prescription drugs (including medical and non-medical use) and other commonly used drugs. In view of this, this paper aims to review the medical, clinical and pharmacological literature to enable an assessment of those drug groups that as side effects have the potential to have an adverse effect on the skeleton, and explore whether or not they can influence the estimation of age-at-death, sex and other indicators of the biological profile. Moreover, it may be that the observation of certain alterations or inconsistencies in the skeleton may relate to the use of drugs or medication, and this in turn may help narrow down the list of missing persons to which a set of human remains could belong. The information gathered from the clinical and medical literature has been extracted with a forensic anthropological perspective and provides an awareness on how several drugs, such as opioids, cocaine, corticosteroids, non-steroidal anti-inflammatory drugs, alcohol, tobacco and others have notable effects on bone. Through different mechanisms, drugs can alter bone mineral density, causing osteopenia, osteoporosis, increase the risk of fractures, osteonecrosis, and oral changes. Not much has been written on the influence of drugs on the skeleton from the forensic anthropological practitioner perspective; and this review, in spite of its limitations and the requirement of further research, aims to investigate the current knowledge of the possible effects of both prescription and recreational drugs on bones, contributing to providing a better awareness in forensic anthropological practice and assisting in the identification process of the deceased.

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Section: Antiretroviral Therapymentioning

confidence: 99%

How Do Drugs Affect the Skeleton? Implications for Forensic Anthropology

Márquez‐Grant

Baldini

Jeynes

et al. 2022

Biology

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show abstract

Section: Introductionmentioning

confidence: 99%

“…Nearly 40% of these patients suffering from HIV develop HIV-associated neuropathy which is also referred to as HIV-distal symmetrical polyneuropathy (HIV-DSP) [ 4 ]. Human immunodeficiency virus-distal symmetrical polyneuropathy in patients can be attributed to the effects of post-anti-retroviral therapy (ART) or the chronicity and debilitation of the condition itself [ 1 , 4 ]. There have been several studies exploring other neurological phenomena associated with HIV such as autonomic neuropathy, peripheral facial paralysis (PFP), and neurocognitive difficulties [ 5 - 7 ].…”

Section: Introductionmentioning

confidence: 99%

Neuropathy in Human Immunodeficiency Virus: A Review of the Underlying Pathogenesis and Treatment

Motwani¹,

Asif²,

Patel³

et al. 2022

Cureus

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This article explores the various causes of the human immunodeficiency virus (HIV), and its associated neuropathy, including the effects of HIV on the nervous system and the long-standing therapy that is often provided to patients with HIV. Several studies regarding the neurotoxic effects of combined antiretroviral therapy (cART) and HIV were reviewed and various hypotheses were discussed. Furthermore, we present the nature of HIV-sensory neuropathy (HIV-SN) among different demographic populations and their subsequent risk factors predisposing them to this condition. It was observed that the incidence of the disease increases in increased survival of the patients as well as in males. Finally, the current approach to HIV-SN and its overlapping features with other causes of peripheral neuropathy have been discussed which demonstrates that a clinical examination is the most important clue for a healthcare professional to suspect the disease. Our main aim was to study the current perspectives and guidelines for diagnosing and managing a patient with HIV-SN to reduce disease prevalence and bring about a more aware frame of mind when following up with an HIV patient.

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“…One-third of those diagnosed with HIV/AIDS are reported to have peripheral neuropathies that can be caused by the virus itself, opportunistic infections, or as a side effect of some drugs used [8] . Nondepolarizing neuromuscular blocking agents bind competitively to the nicotinic acetylcholine receptor (AchR) on the peripheral neuromuscular junction, blocking the ability of acetylcholine to produce depolarization and leading to flaccid paralysis [9] .…”

Section: Introductionmentioning

confidence: 99%

Residual Neuromuscular Block in HIV-Infected Young Patients: A Prospective Observational Study

Hou¹,

liu

et al. 2021

Preprint

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Objectives: Avoidance of residual neuromuscular blockade (RNMB) is crucial to decrease anesthesia-related pulmonary complications. At present, no data are available for HIV-infected patients about the occurrence of RNMB. In this trial, we aim to investigate the incidence of RNMB in such patients. Methods: Data were prospectively collected on 45 normal and 45 HIV-infected patients (18-65 yr). The train-of-four stimulation (TOF-Watch SX) was used to evaluate the level of neuromuscular block from the induction of anesthesia to back to the postanesthesia care unit (PACU) by an assessor, but blind to the anesthesiologist. Primary endpoint was the presence of RNMB at PACU admission, defined as a train-of-four (TOF) ratio < 0.9. The onset time (from application of cisatracurium to maximum depression of T1), no reaction time (from zero of T1 to non-zero), and clinical duration (from application to 25% recovery of T1) were determined for each patient. Results: The incidence of RNMB was 37.5% in HIV- infected patients and 32.5% in normal patients (difference, 5%; 99% CI, −16% to 26 1%; p=0.815). The onset time was no different between two groups (4.05±0.88 min in HIV-infected group vs. 3.85±1.08 min in normal group (p=0.37)). The no reaction time was also similarly between two groups ( 49.83±3.81min in HIV-infected group vs. 48.98±5.12min in normal group (p=0.40)). The clinical duration was 53.78±3.05 min and 52.40±5.02 min in HIV-infected group and normal group, respectively (p=0.14). Conclusion: The odds of RNMB were not significantly different in HIV-infected young patients compared to normal persons.

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Neuropathy complication of antiretroviral therapy in HIV/AIDS patients

Cited by 7 publications

References 25 publications

How Do Drugs Affect the Skeleton? Implications for Forensic Anthropology

How Do Drugs Affect the Skeleton? Implications for Forensic Anthropology

Neuropathy in Human Immunodeficiency Virus: A Review of the Underlying Pathogenesis and Treatment

Residual Neuromuscular Block in HIV-Infected Young Patients: A Prospective Observational Study

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