Neuropathies and HIV retrovirus infections |
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Authors: | J L Gastaut J A Gastaut J F Pellissier J B Tapko M Finaud J R Delpero T Gamby O Weill Y Carcassonne |
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Institution: | Service de Neurologie, H?pital de Sainte-Marguerite, Marseille, France. |
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Abstract: | Neurologic complications are frequently observed during HIV-related infections and particularly in AIDS. According to the literature, these complications more often pertain to the central nervous system (CNS) than the peripheral nervous system (PNS). A prospective study was carried out in order to determine the frequency and type of PNS disorders during HIV infections, the neurotropism of which is now well established. Forty-one HIV-infected patients - 5 asymptomatic subjects, 14 ARC (AIDS-related complex) and 22 AIDS patients - were studied from a clinical and biological angle; 40 equally underwent an EMG and nervous conduction velocity tests, 26 a lumbar puncture and 25 a nervous biopsy (associated in three cases with a muscular biopsy). The study showed that a PNS-alteration is extremely frequent (36/41, or 88% of all cases), generally mild or even subclinical (17/36); most often, the aspect is that of a sensitive axonal polyneuropathy. More severe types (polyradiculoneuritis, sensorimotor polyneuropathy, etc.) are equally observed, but much rarer. Whatever their form may be, the PNS-lesions can be observed in so-called asymptomatic subjects (2/5) as well as ARC (12/14) and AIDS (22/22) patients. They are the manifestation either of a direct lesion of the nerve through HIV, or of immune mechanisms (of humoral or cellular mediation) or of both mechanisms combined. |
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