HIV related motor neuron disease/syndrome: The - potentially treatable - retroviral link in ALS?

Mochan, Andre

doi:10.1016/j.jns.2018.12.029

Cited by 5 publications

(7 citation statements)

References 11 publications

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“…The association between HIV and MND is more strongly confirmed in a recent study from South Africa involving a cohort of 35 HIV positive MND patients with a similar reported 10 year survival of 48% in the ART treated cohort versus 3% in the HIV uninfected MND cohort 50 . This novel association of MND with HIV and apparent response of MND to ART is reviewed in a recent editorial suggesting the reactivation of latent retroviral infection as the likely aetiological agent in HIV associated MND 51 .…”

Section: Discussionmentioning

confidence: 99%

Neurological disorders in Northern Tanzania: A 6-year prospective hospital-based case series

Howlett¹,

Urasa²,

Maro³

et al. 2022

Afr H. Sci.

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Background:The burden of neurological disorders is large and altered by the HIV epidemic. Objectives: We describe the pattern of neurological disorders and their association with HIV infection in adult patients attending a consultant hospital in Northern Tanzania. Methods: In this prospective cross-sectional study, we collected data on adult neurological referrals over a 6-year period between 2007-13. The odds of HIV infection, across neurological categories adjusted for age and sex, was calculated. Results: Of 2037 participants, 54.8% were male and 45.2% were female. The median age of participants was 43 years. The results for HIV screening were available for 992/2037 (48.7%) patients, of whom 306 (30.8%) were seropositive. The most frequent neurological disorders were cerebrovascular disease (19.9%), paraplegia (13.6%), and peripheral neuropathies (8%). Taken together CNS infection accounted for 278/2037 (13.6%). The adjusted odds (aOR) of HIV infection was highest amongst infections; brain abscesses (aOR 107, 95% CI 35.1-470.4) and meningitis/encephalitis (aOR 40.1, 95% CI 13.6-172.9), but also raised in cerebrovascular disease, paraplegia, peripheral neuropathies, cranial nerve palsies, seizures, cerebllar disorders, movement disorders, motor neuron disease andheadache. Conclusion: The main pattern of neurological disorders in Northern Tanzania is presented. The odds of HIV infection was highest in CNS infections and in a wide range of non-communicable neurological disorders. Keywords: Tanzania; neurological; disorder; neurological disease; hospital; HIV

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Section: Discussionmentioning

confidence: 99%

Neurological disorders in Northern Tanzania: A 6-year prospective hospital-based case series

Howlett¹,

Urasa²,

Maro³

et al. 2022

Afr H. Sci.

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“…18 The reported MND prevalence rates among Black African HIV-infected and HIV-uninfected patients are respectively 2.4 and 0.44 cases per 100,000. 7,19 HIV was suggested to be a causal confounder. 7,19 Clinically, HIV-ALS is identical to sALS in HIV-negative patients but occurs younger, is more severe and progressive.…”

Section: Discussionmentioning

confidence: 99%

“…7,19 HIV was suggested to be a causal confounder. 7,19 Clinically, HIV-ALS is identical to sALS in HIV-negative patients but occurs younger, is more severe and progressive. It can be arrested or (partially) reversed by initiation or optimisation of ART.…”

Section: Discussionmentioning

confidence: 99%

“…A (retro)viral aetiology in sALS has been hypothesized. [19][20][21][22] Motor neuron cells are vulnerable to certain viruses, illustrated by poliomyelitis virus which targets anterior horn cells. HIV can occur in the microglial cells of the CNS but is not identified to invade motor neurons.…”

Section: Discussionmentioning

confidence: 99%

“…10,11,20,22 The serum of this patient could unfortunately not be tested for HERV-K. Our first report from Tanzania supports the notion that HIV-ALS can be a treatable entity also in Africa. 7,19 Teaching points…”

Section: Discussionmentioning

confidence: 99%

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Ten-year plateau phase in human immunodeficiency virus induced motor neuron disease upon antiretroviral therapy: a first case from Eastern Africa.

Bruin

Assay

Osman

et al. 2020

rrnmf

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We report an individual with rapidly progressive motor neuron disease (MND), phenotypically compatible with amyotrophic lateral sclerosis (ALS). The patient described in this case report proved positive for human immunodeficiency virus (HIV) and was initiated on antiretroviral therapy (ART). Following ART he clinically stabilised over 10 years and deteriorated again due to noncompliance or ART resistance. HIV infection can give rise to an MND mimic, HIV-ALS. The improvement in response to ART supports the notion that HIV-ALS is a treatable entity also in Africa. This is the first case report of a patient with HIV-ALS and long term follow up in Sub-Saharan Africa. The report raises the suggestion that an additional (retro)virus can play a role in the aetiology of ALS.

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<em>Mycobacterium paratuberculosis</em>: A HERV Turn-On for Autoimmunity, Neurodegeneration, and Cancer?

Dow,

Pierce,

Sechi

2024

Preprint

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Human endogenous retroviruses (HERV) are remnants of ancient retroviral infections that, over millions of years, became integrated into the human genome. While normally inactive, environmental stimuli such as infections have contributed to the transcriptional reactivation of HERV promoting pathological conditions including the devel-opment of autoimmunity, neurodegenerative disease and cancer. What infections then trigger HERV activation? Mycobacterium avium subspecies paratuberculosis (MAP) is a pluripotent driver of human disease. Aside from granu-lomatous diseases Crohn’s, sarcoidosis and Blau syndrome, MAP is associated with autoimmune disease: type one diabetes (T1D), multiple sclerosis (MS), rheumatoid arthritis and autoimmune thyroiditis. MAP is also associated with Parkinson’s disease. Autoimmune diabetes, multiple sclerosis and rheumatoid arthritis are the diseases with the strongest MAP/HERV association. There are several other diseases associated with HERV activation including diseases whose epidemiology and/or pathology would prompt speculation for a causal role of MAP. These include non-solar uveal melanoma, colon cancer, glioblastoma and amyotrophic lateral sclerosis (ALS). This article further points to MAP infection as a contributor to autoimmunity, neurodegenerative disease and cancer via unsilencing of HERV. We examine the link between the ever-increasing number of MAP- associated diseases, the MAP/HERV intersection with these diverse medical conditions and propose treatment opportunities based upon this association.

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HIV related motor neuron disease/syndrome: The - potentially treatable - retroviral link in ALS?

Cited by 5 publications

References 11 publications

Neurological disorders in Northern Tanzania: A 6-year prospective hospital-based case series

Neurological disorders in Northern Tanzania: A 6-year prospective hospital-based case series

Ten-year plateau phase in human immunodeficiency virus induced motor neuron disease upon antiretroviral therapy: a first case from Eastern Africa.

<em>Mycobacterium paratuberculosis</em>: A HERV Turn-On for Autoimmunity, Neurodegeneration, and Cancer?

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