Peripheral neuropathies are a frequent complication of HIV-1 infection and in the setting of AIDS. A wide range of disorders has been described, and their causes are diverse. Some neuropathies are related to HIV-1 itself, or HIV-induced immune mediated mechanisms, and in other cases, it may be related to toxic complications of therapy, complications of systemic HIV-1 illness, nutritional deficiencies, metabolic derangements, opportunistic infections, or neoplasms ( ,i,Iabie 44:11 ). The four major HIV-1- associated peripheral neuropathy syndromes have well-defined clinical characteristics ( ,,Tab]e,i,,44-12. ). Distinguishing clinical features that aid in the diagnosis, management, and, at times, prognosis of patients are stage of HIV-1 disease and CD4+ lymphocyte count, rate of symptom progression, degree of weakness relative to sensory loss, and characteristic electrophysiological findings.
Different neuropathic syndromes occur with increased prevalence at particular stages of HIV-1 disease. Some syndromes are encountered frequently whereas others are rare. In general, the overall incidence of peripheral neuropathies increases with advancing systemic disease, progressive immunodeficiency, and declining CD4+ counts.Wi By
_TABLE 44-11 -- PERIPHERAL NEUROPATHIES ASSOCIATED WITH HIV-1 INFECTION_
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