Motor neuron disease in patients with HIV infection (P2.305)

Objective: The aim of clinical report was to describe patients with HIV infection who developed MND.

Background: HIV-associated motor neuron disease (MND), or amyotrophic lateral sclerosis (ALS)-like syndrome associated with HIV infection, is a rare manifestation of HIV infection. In the last years, ALS-like syndrome has been rarely reported associated with HIV infection. However, because its characteristics are different of classical ALS, the term “HIV-associated motor neuron disease” has been preferred to distinguish this rare manifestation of HIV infection. The prevalence of ALS was estimated to be greater in patients with HIV infection, but HIV-associated MND was identified only in few cases to date. As ALS-like syndrome, HIV-associated MND presents neurologic manifestations that are indistinguishable from “classic ALS”, except that it may has an early onset and beneficial response to ARV therapy.

Design/Methods: We analyzed two Brazilian patients with HIV infection who developed MND.

Results: The diagnosis of HIV infection was concomitant with diagnosis of MND in one patient and it occurred eight years before the MND symptoms in one patient. The manifestation of MND in our patients with HIV infection was similar to the classic ALS. The antiretroviral therapy improves their HIV infection. However, slow progression of MND occurred in the two patients despite the antiretroviral therapy. One patient died.

Conclusions: HIV-associated MND should be differentiated from classical ALS because it is potentially reversible after antiretroviral treatment but early treatment with CNS-penetrating drugs should be done.

Disclosure: Dr. Lorenzoni has nothing to disclose. Dr. Ducci has nothing to disclose. Dr. Dalladone has nothing to disclose. Dr. Kay has nothing to disclose. Dr. Werneck has nothing to disclose. Dr. Scola has nothing to disclose.