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Neurology. 2016 Oct 25;87(17):1756-1762. Epub 2016 Sep 24.

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

Author information

1
From the Section of Infections of the Nervous System, National Institute of Neurological Diseases and Stroke (L.N.B., R.T., W.L., T.A., B.S., A.N.), and National Institute of Allergy and Infectious Diseases (M.W.), NIH, Bethesda, MD; and National Neurological AIDS Bank and Department of Neurology (E.J.S.), University of California, Los Angeles.
2
From the Section of Infections of the Nervous System, National Institute of Neurological Diseases and Stroke (L.N.B., R.T., W.L., T.A., B.S., A.N.), and National Institute of Allergy and Infectious Diseases (M.W.), NIH, Bethesda, MD; and National Neurological AIDS Bank and Department of Neurology (E.J.S.), University of California, Los Angeles. natha@ninds.nih.gov.

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.

PMID:
27664983
PMCID:
PMC5089528
DOI:
10.1212/WNL.0000000000003258
[Indexed for MEDLINE]
Free PMC Article

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