Hemochromatosis Gene Cuts HIV-Related Neuropathy

Iron-loading mutation in hemochromatosis gene reduces neuropathy by nearly sixfold

MONDAY, July 31 (HealthDay News) -- A common iron-loading mutation in the hemochromatosis gene (HFE) is associated with a lower risk of peripheral neuropathy during nucleoside reverse transcriptase inhibitor (NRTI) therapy for HIV infection, according to a study in the July 13 edition of AIDS.

Asha R. Kallianpur, M.D., M.P.H., from Vanderbilt University School of Medicine in Nashville, Tenn., and colleagues genotyped HFE in 509 participants enrolled in the AIDS Clinical Trials Group study 384, who were randomized to receive three or four drug antiretroviral regimens and had up to three years of follow-up.

The researchers found that 29 percent developed peripheral neuropathy according to standard criteria, 73 percent of whom were receiving didanosine plus stavudine. Within this group, heterozygous carriers of a C282Y HFE mutation were less likely to develop peripheral neuropathy than non-carriers (6 percent versus 35 percent, respectively, in whites).

The authors suggest that the mutation maintains proper iron balance in peripheral neurons during infiltration of activated macrophages, which results in reduced neurotoxicity. "This finding has potential implications for the prediction and prevention of NRTI-associated peripheral neuropathy, particularly in populations at risk of iron deficiency," they write.

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