Association between motor neuron disease and HIV infection: A systematic review of case reports

Background Motor neuron disease (MND) is a well-known group of neurodegenerative diseases, with amyotrophic lateral sclerosis (ALS) being the most common form. Since 1985, a possible association between MND/ALS and HIV infection has been described. Methods We performed a systematic review of case re...

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Bibliographic Details
Published in:International journal of STD & AIDS 2025-01, Vol.36 (1), p.24-35
Main Authors: Fernandes, João Paulo Moreira, Garcia, Leonardo Peixoto, Gouhie, Felipe Araújo, Pereira, Raquel Campos, Santos, Diogo Fernandes dos
Format: Article
Language:English
Subjects:
Adult
Amyotrophic Lateral Sclerosis - complications
Amyotrophic Lateral Sclerosis - drug therapy
Female
HIV Infections - complications
HIV Infections - drug therapy
Humans
Male
Middle Aged
Motor Neuron Disease - complications
Riluzole - therapeutic use
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Summary:Background Motor neuron disease (MND) is a well-known group of neurodegenerative diseases, with amyotrophic lateral sclerosis (ALS) being the most common form. Since 1985, a possible association between MND/ALS and HIV infection has been described. Methods We performed a systematic review of case reports and case series involving people living with HIV with MND/ALS through PubMed, Bireme, Embase, and Lilacs databases. The risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tool for Case Reports. Results We analyzed 36 articles presenting 88 cases. The mean age was 41.6 years. Antiretroviral therapy (ART) was used by 89.8% and riluzole by 16.9%. First signs and symptoms were similarly present on cervical/upper (25%) and lumbosacral/lower limbs (23.9%), mostly with fasciculations (69.8%) and hyperreflexia (58.8%). MND had a progressive course in 32.9% patients and a clinical improve in 54.6% following ART. The mean survival of the 32 patients who died was 12.3 months and the mean survival of the living patients was 62 months. Respiratory failure was the main cause of death (35.7%). Conclusions MND/ALS may present differently in the people living with HIV as a rapidly progressive disease in younger people but with the potential to improve weakness and survival through antiretroviral therapy.
ISSN:0956-4624
1758-1052
1758-1052
DOI:10.1177/09564624241288283