INTRODUCTION
Improvements in the medical management of human immunodeficiency virus (HIV) disease have led to
reduced mortality and an increased need to address debilitating co-morbidities such as HIV associated
distal sensory polyneuropathy (DSP).' In persons with HIV disease, DSP can arise from viral infection,
advanced immunosuppression, exposure to anti-tuberculosis drugs, or exposure to certain antiretroviral
drugs used to manage HIV, including stavudine, didanosine (ddl), and zalcitbane (ddC).1'3 Risk factors
for the development of HIV-DSP include older age, lower CD4 nadir, current antiretroviral therapy (ART)
use, and past use of certain nucleoside reverse transcriptase inhibitors as part of ART.'