HIV is associated with painful peripheral neuropathy. Disability is often significant.
Alpha-Lipoic Acid's antioxidant properties may have benefit in this condition.
HIV is associated with painful distal peripheral polyneuropathy in up to 35-50% of those
without AIDS and in more than 70% of those with advanced disease. The condition is
progressive but may be halted with disease remission. Disability is often significant.
Peripheral nerve axons and sensory neuron cell bodies in the dorsal root ganglia are the
principal targets of the process leading to symptoms. Alpha-lipoic acid occurs naturally in
every cell of the body. In high concentrations it acts as an anti-oxidant which regenerates
other anti-oxidants and promotes glutathione synthesis. Clinical studies for diabetic
neuropathy have shown significant benefit at daily oral doses that are well-tolerated.
This placebo-controlled study is designed to evaluate the effects of daily oral alpha-lipoic
acid supplements (600mg, three times per/day) plus standard medical care in the treatment of
painful HIV-associated neuropathy over a 24-week period in adult subjects. Possible
benefits of the study include reduction in pain and disability, reduced use of medications,
and enhanced cellular metabolism.
- Distal peripheral sensory neuropathy as diagnosed by a neurologist with pain or
paresthesia, with or without numbness or weakness
- Able to understand and participate in protocol activities
- Able to give informed consent
- Under the care of a UNC ID Clinical physician for at least 2 months
- Able to document pain characteristics, use of pain medications, and other assessment
instruments and characteristics
- On stable antiretroviral therapy (or none) for 12 weeks prior to enrollment
- No changes in peripheral neuropathy pharmacologic treatment for 12 weeks prior to
- Any significant cognitive impairment or psychosis
- Pregnancy or anticipated pregnancy (women of child-bearing potential must agree to
use birth control for the duration of the study)
- Undergoing any current treatment for malignancy, including chemotherapy or radiation
therapy within the past year
- Concurrent or prior use of a-LA
- Known non-HIV risk factors for peripheral neuropathy, such as DM, B12/folate
deficiency; thyroid dysfunction; hx of exposure to lead, mercury, arsenic, thallium
(prior diagnostic tests permitted), other heavy metals or complex hydrocarbons
- Use of metronidazole, isoniazid or other furantoins
- Suspected or documented thiamin deficiency
- Active alcoholism
- Allergy to a-LA
- Hx of 'significant' use of anti-oxidant supplements during the two months prior to