Culprit? HIV causes Lou Gehrig's disease as some patients.
The AIDS virus can cause a release of amyotrophic lateral sclerosis (ALS), also known as the disease of Lou Gehrig, who can be effectively treated with antiretroviral drugs, according to two studies published in the September 25 issue of Neurology . The results strengthen the case for a viral cause of ALS and show that at least a few cases of motor neuron disease can be reversed.
As ALS patients become sicker, their motor neurons degenerate, causing muscles to atrophy throughout the body. Despite decades of research, it is still unclear what kills neurons. Researchers have long suspected a virus, possibly related to HIV or polio, but the evidence was circumstantial. To see if HIV has been associated with motor neuron disease, neurologist Antoine Moulignier the Rothschild Hospital in Paris, France, and colleagues examined the records of 1,700 patients with HIV or neurological symptoms that were treated the hospital between 1987 and 00.
researchers identified six patients infected with HIV who have developed symptoms of ALS, affecting 27 times higher than the general population. The syndrome developed much faster than ordinary ALS, a few weeks or months, instead of 2 to 5 years; it also struck at a younger age. The researchers tested tissue samples to rule out other causes of neurodegeneration, such as herpes, cytomegalovirus and syphilis. Although ordinary SLA is irreversible, two patients with the syndrome recovered after new antiretroviral drugs have beaten the virus into submission.
In a separate document, neurologist Daniel MacGowan's Beth Israel Medical Center in New York and colleagues report a similar case: a 32 year old woman who quickly developed symptoms of ALS and was quickly found HIV positive . At first, the woman was bedridden, eat through a tube and unable to speak. She recovered completely after treatment for one year with three antiretroviral drugs that made undetectable levels of the virus.
The New York case was "a kind of revolutionary because most ALS syndromes are not getting better," says neurologist Rowland Lewis of Columbia University in New York City. Reports indicate that researchers should test patients to see if HIV infection increases the risk of symptoms of ALS-like, and "he again raises the question of whether the SLA is itself caused by another persistent viral infection, "he concludes.
Related Sites
Background on ALS, the National Institute of neurological disorders and Stroke
General Information HIV / AIDS Centers for Disease Control and Prevention
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