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Distal symmetrical polyneuropathy (DSP) is one of the most debilitating problems seen in patients taking NRTIs. The condition is thought to result from a disruption of neuronal mitochondrial synthesis. Previous studies have noted that serum acetyl-L-carnitine (ALCAR) levels are decreased in NRTI-associated DSP. ALCAR is believed to promote energy metabolism of sensory neurons, which could relieve the symptoms of DSP by enhancing nerve regeneration. This article summarized the results of an open-label pilot study examining the effect of oral ALCAR (1500 mg twice daily) taken for up to 33 months in 21 HIV-infected patients with established NRTI-associated DSP.
The study included an evaluation of neuropathic grade, using quantitative immunohist…