This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. A multicenter, open-label, 24-week pilot study with dose escalation of acetyl-L-carnitine (ALC) for the treatment of distal symmetric peripheral neuropathy (DSPN) associated with dideoxynucleosides in HIV-infected subjects. Gracely pain scale assessments and safety information will be obtained every 6 weeks. An intraepidermal nerve-fiber and subcutaneous adipose tissue biopsy will be obtained at baseline and 24 weeks.