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Cardiac sympathetic denervation, detectable via 123 I-MIBG scintigraphy, is strongly associated with disease progression ( Management complications: Cardiovascular symptoms complicate pharmacotherapy by interacting with anti-parkinsonian drugs that modulate autonomic tone, requiring dose balancing and often necessitating cardiology consultation ( 4.3 HIV co-infection and antiretroviral therapy HIV-positive individuals are at increased risk of parkinsonism due to basal ganglia vulnerability to viral neurotoxicity, chronic inflammation, and mitochondrial stress ( Moreover, antiretroviral therapy (ART), particularly protease inhibitors and nucleoside reverse transcriptase inhibitors, can: Interfere with dopamine metabolism

Amphotericin B nephrotoxicity