HIV neuropathy occurs when the virus damages the nerves of the body. When these nerves do not function properly, they are unable to send sensory signals or messages to the central nervous system, brain, or spinal cord. This can cause pain, tingling, and weakness.
Neuropathy is another word for nerve damage. When the nerves experience damage or function incorrectly, numbness, tingling, weakness, or pain can develop.
Sometimes the condition is also called peripheral neuropathy. It has several causes:
- an underlying condition, such as diabetes
- physical damage or injury to the nerves
- a viral infection, such as HIV or shingles
- a side effect of medication
- a result of drinking too much alcohol
Advances in treatment for HIV mean that people can live longer with the disease than ever before. However, this also means they are more likely to develop certain complications over their lifetime, including HIV neuropathy.
Around 1 in 3 people with HIV or AIDS experience some HIV peripheral neuropathy.
Keep reading to learn more about HIV neuropathy, including the causes, risk factors, symptoms, and more.
Learn more about neuropathic pain here.
HIV is a viral infection. It attacks the body’s immune system, weakening the body’s ability to fight off everyday infections and diseases. It also increases the risk of complications from those infections and diseases.
As it attacks the immune system, HIV damages the central nervous system, affecting how nerve cells (neurons) function. This can affect the peripheral sensory nerves and cause inflammation in the brain and spinal cord.
Neuropathy tends to appear or become worse as HIV progresses. It is most common in people with advanced HIV or AIDS.
A study in 2021 used machine learning to predict factors that could increase the likelihood of neuropathy in people with HIV. Researchers found 28 different factors that could increase the risk, but some of the most significant factors included:
- being older
- living with HIV for more than 15 years
- exposure to certain antiretroviral medications
- having another chronic condition, such as diabetes
Researchers also found that factors changed depending on how long a person with HIV had their diagnosis. For example, poor mental health and smoking were stronger risk factors in people who had their diagnosis fewer than 15 years ago.
As a result, researchers have called for a better understanding of factors that can contribute to HIV neuropathy and urged doctors to look for patterns in risk factors that may help predict and treat neuropathy earlier.
Neuropathy can cause a range of symptoms, depending on the location of the nerve damage and the type of nerves affected. Symptoms may appear suddenly or slowly over time. They may also get worse at night. Common signs include:
- numbness, tingling, or a burning sensation in the hands and feet
- sharp or throbbing pain
- heightened sensitivity to pain or touch
- difficulty walking or using the hands
- ‘symmetrical’ symptoms on both sides of the body
- dizziness or confusion
- erectile dysfunction
Learn more about what causes tingling in the hands and feet.
A doctor will ask a person about their medical history and perform a physical examination. They will also conduct a thorough neurological examination of the following:
- motor and sensory skills
- nerve function
- hearing and speech
- coordination and balance
- mental status
- changes in mood or behavior
A doctor will also use several screen tests to help diagnose neuropathy, which may include the following:
- Blood, urine, or other bodily fluid sample tests: To check for specific health concerns, monitor current medications, and diagnose any hereditary disorders.
- Brain imaging tests: To look for signs of brain inflammation, tumors, nerve damage, and other abnormalities. They may use a CT scan, an MRI, or another imaging scan to look at the brain.
- Electromyography (EMG): To look for nerve and muscle dysfunction, damage, or disease, by examining muscle activity.
- Biopsy: A doctor may take a small tissue sample from the brain, muscles, or nerves and examine it for signs of a tumor, inflammation, or other abnormality. This requires hospitalization and carries some risk to the person undergoing the procedure.
- Cerebrospinal fluid analysis: To check for bleeding in the brain, infections of the brain or spinal cord, and a buildup of fluid.
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Some symptoms may need aggressive treatment, while a doctor may recommend over-the-counter (OTC) pain relief for milder symptoms.
However, treatment may include one or more of the following options:
- OTC or prescription pain relief
- anti-seizure medications
- analgesics, such as opiates
- corticosteroids to reduce inflammation
- plasma exchange to clear the blood of substances that cause inflammation
Some people with HIV neuropathy may need to have a range of treatments in a pain clinic or hospital.
Learn more about the natural options for treating peripheral neuropathy.
New research is emerging all the time in HIV neuropathy. Researchers are increasingly investigating how HIV affects the nervous system, causing neuropathy, and scientists are developing new treatments for neuropathic pain.
Crucial to this research is examining brain tissues collected from people who died from an AIDS-related illness and sharing samples of this tissue with research laboratories worldwide to use in new studies.
Neuropathy is common in people living with HIV and AIDS, as the infection attacks the body’s nervous system, causing damage and dysfunction in the nerves.
Symptoms include pain, numbness, or tingling in the hands and feet and may progress to cause severe pain and disability.
The risk of neuropathy increases with age and how long a person has lived with a diagnosis of HIV. There is no one treatment for HIV neuropathy because it can affect different parts of the nervous system. Instead, doctors will usually recommend treatment based on the severity of symptoms.