Drug-Related Neuropathy: Low Acetylcarnitine Levels Found

Persons who had peripheral neuropathy which appeared to have been caused by ddI, ddC, or d4T were found to have a notably low level of acetylcarnitine in their blood(1); however, their blood level of L-carnitine was normal. As a control, patients who were taking ddI but did not develop neuropathy were also tested -- and they were found to have acetylcarnitine levels which were only slightly reduced. This study did not give acetylcarnitine to any patients, but suggested trying that experiment to see if the drug could help prevent or treat this kind of neuropathy.

Acetylcarnitine (also spelled acetyl-carnitine) is not the same as L-carnitine (a readily available nutrient), but they are chemically related. The body can convert L-carnitine into acetylcarnitine -- but in this case, since the patients' L-carnitine levels were normal, the researchers suggested that this conversion may have been impaired. Acetylcarnitine is known to be important in nerve functioning and in protecting nerves from injury, in part by enhancing the activity of nerve growth factor.(1)

"Since acetylcarnitine is currently available for the treatment of neuropathies and has no toxic effects, the exogenous supplementation of acetylcarnitine in order to prevent or treat the neurotoxicity of nucleoside analogs appears a reasonable hypothesis."(1)

Comment

Acetylcarnitine is being tested in people for treating a number of conditions, but we do not know of its use in HIV. It can be given orally, but may need to be taken several times a day (until a time-release formulation is made) because it has a short half-life in the body. We do not know if acetylcarnitine is readily available in the U.S. or elsewhere.

This possible treatment needs more research. If you have any information about use of acetylcarnitine with HIV-related conditions, please contact AIDS TREATMENT NEWS, 415/255-0588, or email aidsnews@aidsnews.org.

References

1. Famularo G, Moretti S, Marcellini S. and others. Acetyl-carnitine deficiency in AIDS patients with neurotoxicity on treatment with antiretroviral nucleoside analogues. AIDS. February 1997; volume 11, number 2, pages 185-190.