Neurotoxicity and Side-Effects of Highly Active Antiretroviral Therapy [HAART] on the Central and Peripheral Nerve System

I.   W.   Husstedt; D.      Reichelt; E.      Neuen-Jakob; F.      Kastner; R.   von   Einsiedel; B.      Vielhaber; G.      Arendt; S.      Evers; K.      Hahn

Abstract

Highly active antiretroviral therapy [HAART] has increased the mean survival time in the AIDS stage by up to more than 10 years. Five different groups of antiretroviral medications are known, of which integrase and entry inhibitors represent the latest and most modern substances. The long survival time in the AIDS stage means that side effects and interactions become of greater relevance and have to be differentiated from the symptoms of Neuro-AIDS as such. Side effects of HAART tend to affect the central and peripheral nervous system as well as the muscles. Neurotoxicity of HAART components varies considerably and depends on the substance involved. They are to be considered with the choice of HAART as a treatment, and a corresponding combination of medication must be carefully discussed by the doctor and patient in those cases in which side effects on the nervous system by antiretroviral agents are already present. There are special cases, however, in which the associated side-effects are to be accepted and endured if no other combination of medications is possible-e.g. as a result of resistance development. Knowledge of HAART side effects and interactions with antiepileptics, antidepressants and analgetics are essential for the treatment of patients with Neuro-AIDS.

Keywords: HAART, neurotoxicity, central and peripheral nervous system, interactions

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