Prednisolone as a new approach for treatment of HTLV-1 associated polyneuropathy

We have previously shown the implication of HTLV-1 in polyneuropathy in a HTLV-1 endemic area in Mashhad. Treatment with corticosteroids [prednisolone and methylprednisolone] have been recommended for HTLV-1 associated diseases. In the current study we attempted to evaluate the efficiency of prednisolone in HTLV-1 associated polyneuropathy. All recognized cases of HTLV-1 polyneuropathy admitted to Imam Reza Hospital [between 1999-2004] were selected for the study. The other common causes of polyneuropathy were excluded using biochemical, hematological, and neurologic examination. Anti-HTLV1 IgG assays were carried out and positive anti-HTLV-1 results were then confirmed by Western Blot Analyzing. All of the HTLV-1 associated polyneuropathy patients were given prednisolone, 1mg/ kg and tapering 5mg/ per week, for three month. Muscle force and paresthesia of all cases were returned to normal pattern. This therapeutic regimen led to reduction of disease severity. Muscle force increased to V/V and paresthesia of all cases were severely decreased. The results of present study suggest that immunosuppressive treatment is very effective for HTLV-1 associated polyneuropathy patients

peripheral nervous system complications of HIV infection

More than half of HIV-infected persons develop symptomatic neurological disease. The nervous system is extensively involved with no part of the neuraxis being immune from the virus. HIV-associated neuropathies have become the most frequent neurological disorder associated with HIV infection. The most common forms of HIV-associated neuropathies are the distal sensory polyneuropathy [DSP] and antiretroviral toxic neuropathy. Other forms include acute or chronic inflammatory polyneuropathies. Mononeuritis multiplex or radiculopathies may occur in late stages and are mostly associated with opportunistic infections. Furthermore, HIV-related muscle involvement is an uncommon but important complication. This may be due to polymyositis, HIV-associated wasting syndrome or may be aggravated by drugs. The aim of this review is to evaluate the available data on clinical manifestations, pathogenesis, investigations and the therapeutic implication for peripheral nervous system [PNS] neuropathies complications of HIV/AIDS. This review summarises those issues that are likely to confront clinicians, including those who do not routinely treat people infected with HIV