Treatment of the neuromuscular complications of human immunodeficiency virus infection

Neuromuscular disorders are increasingly being reported in individuals with human immunodeficiency virus (HIV) infection. The majority of these disorders resemble diseases occurring in HIV‐seronegative patients and include inflammatory demyelinating polyneuropathies, multiple mononeuropathies, and polymyositis. In HIV‐seronegative patients, these diseases are believed to be immune system‐mediated. It is likely that similar pathogenic mechanisms are present in HIV‐seropositive patients and reflect an altered immune system caused by viral infection and the loss of CD4 cells. Therapy is similar in both seropositive and seronegative patients with inflammatory demyelinating polyneuropathies, but plasmapheresis is preferred in seropositive patients as it is less likely than corticosteroids to induce further immunosuppression. Distal sensory neuropathy is characteristic in patients infected with HIV, especially those with the acquired immunodeficiency syndrome (AIDS) or AIDS‐related complex, and may be a consequence of HIV infection. Therefore, antiviral agents may have a therapeutic role for this disorder.