HIV-associated motor neuron disease

Lauren N. Bowen, Richa Tyagi, Wenxue Li, Tariq Alfahad, Bryan Smith, Mary Wright, Elyse J. Singer, Avindra Nath

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)1756-1762
Number of pages7
JournalNeurology
Volume87
Issue number17
DOIs
StatePublished - Oct 25 2016
Externally publishedYes

ASJC Scopus subject areas

  • Clinical Neurology

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  • Cite this

    Bowen, L. N., Tyagi, R., Li, W., Alfahad, T., Smith, B., Wright, M., Singer, E. J., & Nath, A. (2016). HIV-associated motor neuron disease. Neurology, 87(17), 1756-1762. https://doi.org/10.1212/WNL.0000000000003258