One group of drugs that is effective in fighting HIV may, paradoxically, also be promoting the death of sensory nerves in the skin, according to a study presented October 5, 2004, at the 129th annual meeting of the American Neurological Association in Toronto.
A team of American and Australian researchers reported that the use of certain anti-HIV drugs, called dideoxynucleosides, is highly correlated with a condition called sensory neuropathy, in which patients experience constant pain, and abnormal sensations including numbness and sensitivity, in the feet and legs. In a separate presentation, presented on October 4, the same investigators showed that simple punch skin biopsies are an effective way of identifying sensory neuropathy, possibly even before symptoms appear.
Dideoxynucleosides, members of a class of drugs called 'nucleoside reverse transcriptase inhibitors' are common component of highly active antiretroviral therapy (HAART), the so-called AIDS "cocktails" that prevent HIV from duplicating itself. The authors noted that these drugs are frequently included in the generic HAART combinations used in Africa and India.
"Because the introduction of HAART has reduced the rates of HIV-associated dementia and opportunistic infections, sensory neuropathies have become the commonest neurological disorders associated with AIDS," said lead author Justin C. McArthur, MD, of Johns Hopkins University in Baltimore, Maryland.
The factors that lead to HIV-associated sensory neuropathy are not clear. Diabetes, intravenous drug use, or hepatitis C may contribute to heightened susceptibility, along with some of the same drugs that help protect against HIV.