AAEM MINIMONOGRAPH NUMBER 41 - NEUROMUSCULAR DISEASES ASSOCIATED WITHHIV-1 INFECTION

Neuromuscular diseases occur in as many as 50% of patients infected wi th human immunodeficiency virus type 1 (HIV-1). All forms of neuromusc ular disease have been reported, including axonal neuropathy, demyelin ating neuropathy, mononeuropathy multiplex, polyradiculitis, ALS-like syndromes, disorders of neuromuscular transmission, myopathy, and toxi c neuropathies due to medication side effects. Neuromuscular disease i s often the presenting manifestation of HIV-1 infection. Infection wit h cytomegalovirus (CMV) is associated with different types of neuropat hy including mononeuritis multiplex and polyradiculopathy. There is ef fective treatment for many of the associated disorders including chron ic inflammatory demyelinating neuropathy, CMV-mediated neuropathies, a nd myopathy. Treatment of CMV-mediated mononeuropathy multiplex may be life saving. The different neuromuscular syndromes associated with di fferent stages of HIV-1 infection may be due, in part, to different le vels of immunocompetence.