The purpose of this study is to determine the safety, tolerability and efficacy of pain relief of lidoderm 5% gel for HIV-associated neuropathy. Painful peripheral neuropathies represent the most common neurological complication in patients infected with HIV. Painful distal sensory polyneuropathy (DSP) is the most common peripheral neuropathy in AIDS patients, occurring in about 20% to 35% of patients. The signs and symptoms of DSP include pain primarily in the feet, diminished primary sensory modalities in the feet, and decreased ankle reflexes with minimal foot weakness. The mechanism of DSP in AIDS is unknown. The incidence of DSP increases with advancing immunosuppression in later stages in the course of AIDS. The effectiveness of the new topical lidocaine formulations in the treatment of post-herpetic neuralgia pain suggest that these agents might be useful in treating the pain of HIV DSP. Because topical application of lidocaine has a very low potential for side effects or addiction, this type of treatment could become one of choice for a large number of patients. Lidocaine is an amide-type local anesthetic and is known to stabilize neuronal membranes by inhibiting the ionic fluxes required for the initiation and conduction of impulses. Lidoderm preparations, when applied to intact skin in post-herpetic neuralgia provides dermal analgesia through analgesic modulation of abnormally functioning fibers, rather than interfering with normal nerve fiber function.
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