Is motor neurone disease in HIV a treatable disorder?

 HIV-associated motor neuron disease. HERV-K activation and response to antiretroviral therapy

Bowen LN, Tyagi R, Li W, et al.

Neurology 2016; 87:1756-1762.

Abstract

OBJECTIVE:

To determine whether there is activation of human endogenous retrovirus K (HERV-K) in amyotrophic lateral sclerosis in HIV infection and whether it might respond to treatment with antiretroviral drugs.

METHODS:

In this case series, we present 5 patients with HIV infection who subsequently developed motor neuron disease involving both upper and lower motor neurons. We monitored HERV-K levels in plasma of 4 of these patients.

RESULTS:

Three patients who received antiretroviral therapy had reversal of symptoms within 6 months of onset of neurologic symptoms and the other 2 had slow neurologic progression over several years. Three patients in whom the levels were measured at onset of neurologic symptoms showed elevated HERV-K levels that responded to optimization of antiretroviral therapy for CNS penetration.

CONCLUSIONS:

Thus, motor neuron disease in individuals with HIV infection may a treatable entity, but early treatment with CNS-penetrating antiretroviral therapy may be necessary. Monitoring of HERV-K levels may help guide treatment.

This reference is now included in the neurochecklists:

Motor neurone disease (MND): risk factors

HIV associated neurological infections

 

screen-shot-2016-12-24-at-23-32-53

Abstract link

By US National Institute of Health (redrawn by en:User:Carl Henderson) - US National Institute of Health (redrawn by en:User:Carl Henderson)http://web.archive.org/web/20050531012945/http://www.niaid.nih.gov/factsheets/howhiv.htmhttp://web.archive.org/web/20041119131214/http://www.niaid.nih.gov/factsheets/graphics/howhiv.jpg, Public Domain, Link
By US National Institute of Health (redrawn by en:User:Carl Henderson) – US National Institute of Health (redrawn by en:User:Carl Henderson)http://web.archive.org/web/20050531012945/http://www.niaid.nih.gov/factsheets/howhiv.htmhttp://web.archive.org/web/20041119131214/http://www.niaid.nih.gov/factsheets/graphics/howhiv.jpg, Public Domain, Link
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2 thoughts on “Is motor neurone disease in HIV a treatable disorder?

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  1. Exhaustive evaluation and work up is required for diffrent potentially reversible motor neuron syndromes such as viral infections, Neurosyphilis, metabolic disorders before embarking on the diagnosis of ALS.

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