Introduction: There is a clear association between human immunodeficiency virus (HIV) and peripheral neuropathy. Peripheral polyneuropathy (PPN) is the most frequent neurological complication due to both the infection itself and the neurotoxicity deriving from highly active antiretroviral therapies (HAART).
Aims: The aim of this study was to determine the incidence of symptomatic PPN associated to HAART and to find out the true prevalence rate of subclinical neuropathy following over several years' treatment.
Patients and methods: In order to evaluate the incidence of symptomatic PPN we conducted a study of patients undergoing treatment with HAART with a combination of didanosine (ddI), lamivudine (3TC) and efavirenz, and its presence was confirmed both clinically and electromyographically. Moreover, to study the prevalence rate of asymptomatic or subclinical PPN we chose patients without PPN who had been receiving this treatment for more than two years, with a viral load that had remained undetectable for over a year and with no further risk factors for PPN, and submitted them to a voluntary electromyographic study for PPN.
Results: Of the 108 patients studied, only two cases of symptomatic PPN were found.
Conclusions: The incidence rate of clinical neuropathy following the administration of HAART is low (1.85%); PPN is a rare cause of withdrawal. Nevertheless, the prevalence rate found for subclinical PPN in patients undergoing prolonged therapy is high (66%). We therefore find ourselves with a problem that is little known, rarely suspected and more common than is believed.