Compound shown to help reverse anti-HIV drug-related nerve damage

Supplements that contain Acetyl-L-carnitine, a naturally occurring amino acid, have been shown to help reverse nerve damage caused by some anti-HIV drugs, according to a study in the July 23 edition of the journal AIDS. The amino acid was previously shown to relieve pain in patients with HIV-related neuropathy linked to the use of nucleoside reverse transcriptase inhibitors, but no previous study had shown the compound to actually help reverse nerve damage. Researchers at the Royal Free and University College Medical School in London studied 21 HIV-positive patients with neuropathy, giving each 1,500 milligrams of an acetyl-L-carnitine supplement twice a day. At the beginning of the study, all of the patients had an almost complete absence of nerve fibers in the outer and inner layers of the skin and in the sweat glands from their lower legs. Significant increases in the numbers of nerves detected were seen in all the study patients after six months of treatment and persisted through 24 months of treatment. Small sensory nerve fibers posted the biggest gains. Neuropathy-related pain improved in 15 of the study patients. There were no drug-related side effects reported, and the amino acid supplements had no impact on HIV disease treatment. The researchers suggest the amino acid may help reduce drug-related mitochondrial damage through an antioxidant effect and may also improve neuronal metabolic capacity. "Peripheral neuropathy has been the principle complication limiting the use [of NRTIs]," the researchers conclude. Acetyl-L-carnitine "may now offer an effective, pathogenesis-based management approach, allowing patients to remain on NRTI therapy," they add.