Cerebellar degeneration and progressive ataxia associated with HIV-virus infection

• Published in: Parkinsonism & related disorders 2018-09, Vol.54, p.95-98
• Main Authors: Pedroso, José Luiz, Vale, Thiago Cardoso, Gama, Maria Thereza Drumond, Ribas, Gustavo, Kristochik, Julio C.G., Germiniani, Francisco M.B., Fink, Maria Cristina Domingues da Silva, Oliveira, Augusto Cesar Penalva de, Teive, Helio A.G., Barsottini, Orlando G.
• Format: Article
• Language: English
• Subjects: Ataxia; Cerebellum; HIV
• ISSN: 1353-8020; 1873-5126
• DOI: 10.1016/j.parkreldis.2018.04.007

The spectrum of neurologic disorders associated with HIV infection is very broad, resulting from direct virus invasion, opportunistic infections, malignancies and toxic effects of drugs. Among a large cohort of ataxia patients (N = 1050) evaluated between 2008 and 2017, we detected four patients with HIV-infection who developed a pure progressive cerebellar ataxia syndrome combined with cerebellar atrophy. Adverse drug effects, opportunistic infections and malignancies as well as immune-reconstitution syndrome were ruled out based on history and laboratory data. The exact pathophysiological mechanisms of ataxia in HIV patients is not very clear, but seems to be immune-mediated or a direct neurotoxic virus effect leading to apoptosis of Purkinje and granular cells. HIV infection should be investigated in adult patients with undetermined sporadic progressive pure ataxia with cerebellar atrophy. •The spectrum of neurologic disorders associated with HIV infection is very broad.•HIV can trigger HIV-dementia and amyotrophic lateral sclerosis-like disease.•HIV infection is not usually considered the cause of progressive ataxia and cerebellar degeneration.•Include HIV infection when investigating adult patients with progressive pure ataxia.