Merck

Peripheral neuropathy in HIV: an analysis of evidence-based approaches.

The Journal of the Association of Nurses in AIDS Care : JANAC (2014-04-05)
Patrice K Nicholas, Inge B Corless, Linda A Evans
ABSTRACT

Peripheral neuropathy is a common and vexing symptom for people living with HIV infection (PLWH). Neuropathy occurs in several different syndromes and is identified in the literature as distal sensory polyneuropathy or distal sensory peripheral neuropathy. More recently, the HIV literature has focused on the syndrome as painful HIV-associated sensory neuropathy, addressing the symptom rather than the underlying pathophysiology. Assessment of neuropathy in PLWH is critical and must be incorporated into nursing practice for each visit. Neuropathy has been attributed to the direct effects of HIV, exposure to antiretroviral medications (particularly the nucleoside reverse transcriptase inhibitors), advanced immune suppression, and comorbid tuberculosis infection and exposure to antituberculosis medications. Evidence supports the importance of addressing neuropathy in PLWH with pharmacologic treatment regimens and complementary/alternative approaches. This paper examines the pathophysiology, evidence, and approaches to managing peripheral neuropathy. A case study has been included to illustrate a patient's experience with neuropathy symptoms.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Gabapentin, solid
Sigma-Aldrich
2′,3′-Didehydro-3′-deoxythymidine, ≥98% (TLC)
Supelco
Gabapentin, Pharmaceutical Secondary Standard; Certified Reference Material
USP
Gabapentin, United States Pharmacopeia (USP) Reference Standard
Supelco
Gabapentin Related Compound A, Pharmaceutical Secondary Standard; Certified Reference Material
Didanosine for system suitability, European Pharmacopoeia (EP) Reference Standard
Stavudine, European Pharmacopoeia (EP) Reference Standard
Sigma-Aldrich
2′,3′-Dideoxyinosine, ≥98% (HPLC)
Sigma-Aldrich
γ-Aminobutyric acid, BioXtra, ≥99%
Sigma-Aldrich
γ-Aminobutyric acid, ≥99%
Supelco
γ-Aminobutyric acid, analytical standard
Vigabatrin impurity D, European Pharmacopoeia (EP) Reference Standard
Didanosine, European Pharmacopoeia (EP) Reference Standard
Stavudine for system suitability, European Pharmacopoeia (EP) Reference Standard