Age and hydroxyurea increase the risk of drug-associated peripheral neuropathy in HIV-infected patients

Drug-induced peripheral neuropathy is a common complication of highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV) infection. We performed a retrospective observational study to evaluate the association between hydroxyurea (HU) exposure and peripheral neuropathy among patients with HIV disease. We reviewed 158 randomly selected charts from the HIV clinic at our institution and identified 22 cases of physician-defined peripheral neuropathy. We then compared several variables between patients to determine if HU exposure significantly increased the risk of neuropathy. Multivariate regression analysis of several factors, including age, sex, race, drug exposure, viral load, and CD4 lymphocyte count, revealed that both age and HU exposure independently increased the risk of neuropathy. This effect appeared to be additive or synergistic with the pre-existing risk from exposure to other neuropathic drugs. Our data suggest an increased risk of neurotoxicity with increasing age and with the addition of HU to antiretroviral regimens including other drugs known to injure peripheral nerves.