Myopathies

Several types of myopathy may complicate HIV-1 infection. Both inflammatory and noninflammatory myopathies have been described, ranging in severity from asymptomatic creatine kinase elevation to severe proximal weakness. Patients with inflammatory, polymyositis-like illnesses have improved with corticosteroid therapy.
Zidovudine can also cause proximal weakness and loss of muscle mass. This toxic myopathy appears to develop only after prolonged use of the antiretroviral and perhaps relates to the drug’s effect on mitochondria; muscle biopsy may reveal excessive or abnormal mitochondria. Discontinuing the drug usually results in clinical improvement.

Preferences:
Baumbartner JE, Rachlin JR, Beckstead JH, et al: Primary central nervous system lymphomas: Natural history and response to radiation therapy in 55 patients with acquired immunodeficiency syndrome. J Neurosurg 73:206, 1990. Describes an extensive experience with primary CNS lymphoma in AIDS.

Berger JR, Levy RM: AIDS and the Nervous System, 2nd ed. Philadelphia, Lippincott-Raven, 1997. A multi-authored book with a number of useful chapters and extensive primary source references.

Berger J, Lorraine P, Lanska D, Whiteman M: Progressive multifocal leukoencephalopathy in patients with HIV infection. J Neuro Virol 4:59, 1998. A review of experience with PML in AIDS.

Gendelman HE, Lipton SA, Epstein L, Swindells S: The Neurology of AIDS. New York: Chapman & Hall, 1998. Another useful book, though focused heavily on the interactions of HIV-1 with the nervous system.

Navia BA, Jordon BD, Price RW: The AIDS dementia complex. J. Clinical features, Ann Neurol 19517, 1986. Report characterizing the clinical features of the AIDS dementia complex.

Price RW: Management of the neurological complications of HIV-1 and AIDS. In Sande MA, Volberding PA (eds). The Medical Management of AIDS, 5th ed. Philadelphia, W.B. Saunders, 1997, pp 197-216. A review chapter that extends this section.
Zuger A, Louie E, Holzman RS, et al: Cryptococcal disease in patients with the acquired immunodeficiency syndrome: Diagnostic features and outcome of
treatment. Ann Intern Med 104:234, 1986. Describes the clinical features of cryptococcal meningitis in AIDS.

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Revision date: July 3, 2011
Last revised: by Amalia K. Gagarina, M.S., R.D.