Living with HIV in the Philippines: Email 727: ARV's and Neuropathy

Hi Pozzie,

Good day. Im R, 28. May question lang ako sa condition ko, naghahanap ako sa blog mo kung may related sa nararamdaman ko ngayon kaso wala ko mahanap. But first, let me tell you my story. I have myself checked last August 2013 in RITM satellite Malate & unfortunately it turned out positive. I was referred to RITM-ARG and already started my ARVs last September 2013 - avocomb and efavirenz but one month later my doctor changed it to lamivudine, tenofovir & efavirenz. I was also diagnosed with acute TB and
already started my meds.

Last September, my foot started to numb - paresthesia daw tawag dun sabi ng sister kong nurse. Umakyat na sya hanggang legs ko. Ang hirap maglakad, parati ako na-oout of balance. Im taking vit b complex for one month now pero wala pa rin ako nafefeel na improvement. Now kay langan ko ng saklay or tungkod para makalakad. Nagwoworry nako baka malumpo ko soon.

Help naman pozzie, do you know someone who has the same case?

POZZIEPINOY’S RESPONSE

Hi R.

Thank you for your email.

With regards to your email, ARV's can sometimes cause a side effect known as peripheral neuropathy, a nerve damage, often causes weakness, numbness and pain, usually in your hands and feet. If left untreated, this may cause disability.

I have known some who had peripheral neuropathy because of their ARV's. Usually once the ARV's have been switched early on to another cocktail, the neuropathy slowly disappeared.

Your case is an emergency one and you should see your HIV doctor immediately. You need to report what you have been feeling. You can't compromise your other body functions as there are still options to HIV treatment. Your HIV doctor can give you direction on what to do next so please visit your hub immediately. If you want to talk to our peer counsellors, please click the link below:

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I researched about HIV and neuropathy and this is what I found from the internet:

(Source: http://www.hopkinsmedicine.org/neurology_neurosurgery/specialty_areas/peripheral_nerve/conditions/hiv_neuropathy.html)

HIV Neuropathy

Disorders of peripheral nerves are among the most frequent neurological complications of HIV infection. With increasing survival of patients with HIV, the number of patients who have HIV neuropathy is increasing worldwide. HIV can affect peripheral sensory and motor nerves, thoracic nerves, cranial nerves or autonomic nerves. HIV neuropathy can manifest itself in multiple ways. It can affect multiple sensory and motor nerves in distal parts of the limbs and cause HIV polyneuropathy. Sometimes this type of neuropathy is due to a group of anti-HIV medications and is called antiretroviral toxic neuropathy. HIV can also affect one nerve at a time (HIV mononeuropathy) or cause an inflammatory neuropathy similar to Guillain-Barre syndrome (GBS).

Symptoms

The symptoms of HIV neuropathy depend on the type of neuropathy. In HIV polyneuropathy, the patient may experience unusual sensations (paresthesias), numbness and pain in their hands and feet. Often non-painful stimuli, such as touching, can elicit pain sensation. In addition, at later stages of the illness, there may be weakness of the muscles in the feet and hands. In HIV mononeuropathy, the symptoms depend on which nerve is affected. For example, it can affect thoracic nerves and cause numbness and pain in the chest wall or it can affect cranial nerves and cause sensory or motor deficits in the face. In rare cases where HIV causes a GBS-like illness, the symptoms will be very similar to typical GBS.

Diagnosis

Diagnosis of HIV neuropathies is based on history, clinical examination and supporting laboratory investigations. These include electromyography with nerve conduction studies, skin biopsies to evaluate cutaneous nerve innervation, and nerve and muscle biopsies for histopathological evaluation.

Treatment

Treatment of HIV neuropathies depends on the type. Typical HIV polyneuropathy requires good control of HIV infection. Antiretroviral toxic neuropathy may require the cessation of the offending drug. Neuropathic pain due to HIV polyneuropathy can be treated with anti-seizure medications, antidepressants, or analgesics including opiate drugs. In severe painful conditions, patients may be referred to the Blaustein Chronic Pain Clinic for a multidisciplinary approach to pain management. Patients with GBS due to HIV are treated in a similar manner to other GBS patients.

Once again, please consult your HIv doctor R so a better treatment can be put in place.

I hope I was able to answer your concerns. Feel free to email me again if you have other questions.

Stay healthy,

Pozziepinoy

"WE ARE ALL IN THIS TOGETHER.

NO PLHIV is alone with his or her struggle with HIV!"

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