Polyneuropathy induced by HIV disease and antiretroviral therapy

Kokotis, Panagiotis; Schmelz, Martin; Papadimas, Georgios; Skopelitis, Elias; Aroni, Kyriaki; Kordossis, T.; Karandreas, Nikolaos

doi:10.1016/j.clinph.2012.05.022

Cited by 28 publications

(25 citation statements)

References 35 publications

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“…Viral proteins have been shown to preferentially damage large Aβ-fibre myelinated primary afferent axons that convey touch and proprioceptive information, whereas NRTIs preferentially damage small myelinated Aδ fibres and nonmyelinated C fibres that convey temperature and pain information. 32 …”

Section: Hiv-related Peripheral Neuropathymentioning

confidence: 99%

Mitotoxicity in distal symmetrical sensory peripheral neuropathies

2014

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Chronic distal symmetrical sensory peripheral neuropathy is a common neurological complication of cancer chemotherapy, HIV treatment and diabetes. Although aetiology-specific differences in presentation are evident, the clinical signs and symptoms of these neuropathies are clearly similar. Data from animal models of neuropathic pain suggest that the similarities have a common cause: mitochondrial dysfunction in primary afferent sensory neurons. Mitochondrial dysfunction is caused by mitotoxic effects of cancer chemotherapeutic drugs of several chemical classes, HIV-associated viral proteins, and nucleoside reverse transcriptase inhibitor treatment, as well as the (possibly both direct and indirect) effects of excess glucose. The mitochondrial injury results in a chronic neuronal energy deficit, which gives rise to spontaneous nerve impulses and a compartmental neuronal degeneration that is first apparent in the terminal receptor arbor—that is, intraepidermal nerve fibres—of cutaneous afferent neurons. Preliminary data suggest that drugs that prevent mitochondrial injury or improve mitochondrial function could be useful in the treatment of these conditions.

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Section: Hiv-related Peripheral Neuropathymentioning

confidence: 99%

Mitotoxicity in distal symmetrical sensory peripheral neuropathies

2014

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“…However, Schreiber et al (8) observed functional recovery in a HIV (+)-GBS case without HIV treatment, and suggested that a comprehensive investigation is needed on this issue. Additionally, antiretroviral drugs used in HIV treatment was reported to cause acute motor and sensory axonal neuropathy, and it was brought forward that these drugs may also cause neuropathy by mitochondrial toxicity and neuroimmune mechanisms (13,14).…”

Section: Discussionmentioning

confidence: 99%

Guillain-Barré Syndrome and Human Immunodeficiency Virus

Girgin¹,

İşçimen²,

Yılmaz³

et al. 2014

Turk J Anesth Reanim

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“…15,16 Advanced HIV disease and a low CD4-positive cell count have been correlated with lower conduction velocities in peripheral nerves. 17,18 In addition, some nucleotide reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, and protease inhibitors used in ART can have neurotoxic side effects, which are probably related to a dysfunction of mitochondrial oxidative metabolism. In particular, the nucleotide reverse transcriptase inhibitor dideoxynucleoside drugs (such as zidovudine [azidothymidine], didanosine [dideoxyinosine], and zalcitabine [dideoxycytidine]) have been implicated in toxic peripheral neuropathy.…”

mentioning

confidence: 99%

“…The duration of exposure to neurotoxic drugs has been correlated with reduced intradermal nerve fiber density and increased fiber fragmentation. 15,17 Spontaneous pain, paresthesia, and sensory loss are common symptoms of DSP. Clinicians and patients report that the pain often does not respond fully to pharmacological interventions, which typically include anticonvulsants, antidepressants, opioids, and topical medications.…”

mentioning

confidence: 99%