Twenty-five HIV-infected patients being treated with a reverse-transcriptase inhibitor were randomly assigned to receive, in double-blind fashion, 100 mg of coenzyme Q10 (CoQ10) or placebo twice a day for three months. Nine (69%) of 13 patients receiving CoQ10, as compared with 1 (8%) of 12 receiving placebo, reported an improvement in general well-being (p < 0.01). However, CoQ10 treatment appeared to cause an increase in pain in patients with peripheral neuropathy, which then returned to the baseline level of severity when CoQ10 was discontinued.

Comment: Blood CoQ10 levels have been found to be low in patients with AIDS, and CoQ10 deficiency may result in impaired immune function. In an uncontrolled trial, supplementation with 200 mg/day of CoQ10 improved symptoms and reduced the frequency of opportunistic infections. However, the results of the present study suggest that HIV-infected patients with drug-induced neuropathy may have an adverse reaction to CoQ10. Patients who experience an increase in neuropathic pain after taking CoQ10 should consider discontinuing it or reducing the dose.

Rabing Christensen E, et al. Mitochondrial DNA levels in fat and blood cells from patients with lipodystrophy or peripheral neuropathy and the effect of 90 days of high-dose coenzyme Q treatment: a randomized, double-blind, placebo-controlled pilot study. Clin Infect Dis. 2004;39:1371-1379.