Painful HIV Neuropathy and Alpha-Lipoic Acid

Inclusion Criteria: HIV-seropositive Distal peripheral sensory neuropathy as diagnosed by a neurologist with pain or paresthesia, with or without numbness or weakness Able to understand and participate in protocol activities Able to give informed consent Under the care of a UNC ID Clinical physician for at least 2 months Able to document pain characteristics, use of pain medications, and other assessment instruments and characteristics On stable antiretroviral therapy (or none) for 12 weeks prior to enrollment No changes in peripheral neuropathy pharmacologic treatment for 12 weeks prior to enrollment Exclusion Criteria: Any significant cognitive impairment or psychosis Pregnancy or anticipated pregnancy (women of child-bearing potential must agree to use birth control for the duration of the study) Undergoing any current treatment for malignancy, including chemotherapy or radiation therapy within the past year Concurrent or prior use of a-LA Known non-HIV risk factors for peripheral neuropathy, such as DM, B12/folate deficiency; thyroid dysfunction; hx of exposure to lead, mercury, arsenic, thallium (prior diagnostic tests permitted), other heavy metals or complex hydrocarbons Use of metronidazole, isoniazid or other furantoins Suspected or documented thiamin deficiency Active alcoholism Allergy to a-LA Hx of 'significant' use of anti-oxidant supplements during the two months prior to study entry