Hiv感染被视为肌萎缩侧索硬化(Als)样病症的原因
&nbps;&nbps;&nbps;&nbps;WESTPORT, CT (Reuters Health) - Two reports in the September 25th issue of Neurology indicate that HIV infection can cause a reversible form of amyotrophic lateral sclerosis (ALS), supporting the longheld belief that a viral disease may underlie ALS.
&nbps;&nbps;&nbps;&nbps;"This is exciting news, because if this form of ALS caused by HIV is treatable, then other forms of ALS may be treatable as well," Dr. Burk Jubelt, of SUNY Upstate Medical University in Syracuse, said in a statement from the American Academy of Neurology.
, http://www.100md.com
&nbps;&nbps;&nbps;&nbps;In the first report, a French team led by Dr. Antoine Moulignier of Adolphe de Rothschild Foundation in Paris retrospectively identified six cases of ALS-like disorders among 1700 HIV-infected patients with neurologic syndromes seen over a 13-year period.
&nbps;&nbps;&nbps;&nbps;This translates into a frequency of 3.5 cases of ALS-like disorders per 1000 HIV-infected patients, 27-fold higher than the expected rate of ALS in the general population, which varies between 0.4 to 1.76 per 100,000, the authors point out.
, http://www.100md.com
&nbps;&nbps;&nbps;&nbps;Of the six patients, one met criteria for definite ALS while the other five were classified as having probable or possible ALS. All six exhibited rapidly progressive upper and lower motor neuron dysfunction. At onset of ALS-like symptoms, all patients were immunodepressed, with a mean CD4 cell count of 86.2/mm?
&nbps;&nbps;&nbps;&nbps;Antiretroviral therapy led to complete recovery of motor neuron symptoms in two patients, improvement in three, and stabilization in one, Dr. Moulignier and colleagues report. They also report a positive association between an increase in CD4 cell count, reduction in HIV viral load and neurologic improvement, which suggests an etiologic link between the ALS-like condition and HIV.
, http://www.100md.com
&nbps;&nbps;&nbps;&nbps;In the second report, Dr. Daniel J. L. MacGowan and colleagues from Beth Israel Medical Center, New York, describe a 32-year-old woman with progressive ALS-like motor neuron disease and newly diagnosed HIV infection with a CD4 count of 44/mm? Antiviral therapy led to complete and sustained recovery from motor neuron disease in conjunction with undetectable HIV RNA levels.
&nbps;&nbps;&nbps;&nbps;In an accompanying editorial, Dr. Jubelt notes that these seven cases of HIV-associated ALS syndromes differ from classic ALS in that the patients were younger than is typical, neurologic symptoms progressed "unusually rapidly," and the disorder improved with treatment.
&nbps;&nbps;&nbps;&nbps;Clearly more research is needed, Dr. Jubelt writes, but in the meantime, he recommends considering a viral cause in patients who present with signs of ALS., http://www.100md.com
&nbps;&nbps;&nbps;&nbps;"This is exciting news, because if this form of ALS caused by HIV is treatable, then other forms of ALS may be treatable as well," Dr. Burk Jubelt, of SUNY Upstate Medical University in Syracuse, said in a statement from the American Academy of Neurology.
, http://www.100md.com
&nbps;&nbps;&nbps;&nbps;In the first report, a French team led by Dr. Antoine Moulignier of Adolphe de Rothschild Foundation in Paris retrospectively identified six cases of ALS-like disorders among 1700 HIV-infected patients with neurologic syndromes seen over a 13-year period.
&nbps;&nbps;&nbps;&nbps;This translates into a frequency of 3.5 cases of ALS-like disorders per 1000 HIV-infected patients, 27-fold higher than the expected rate of ALS in the general population, which varies between 0.4 to 1.76 per 100,000, the authors point out.
, http://www.100md.com
&nbps;&nbps;&nbps;&nbps;Of the six patients, one met criteria for definite ALS while the other five were classified as having probable or possible ALS. All six exhibited rapidly progressive upper and lower motor neuron dysfunction. At onset of ALS-like symptoms, all patients were immunodepressed, with a mean CD4 cell count of 86.2/mm?
&nbps;&nbps;&nbps;&nbps;Antiretroviral therapy led to complete recovery of motor neuron symptoms in two patients, improvement in three, and stabilization in one, Dr. Moulignier and colleagues report. They also report a positive association between an increase in CD4 cell count, reduction in HIV viral load and neurologic improvement, which suggests an etiologic link between the ALS-like condition and HIV.
, http://www.100md.com
&nbps;&nbps;&nbps;&nbps;In the second report, Dr. Daniel J. L. MacGowan and colleagues from Beth Israel Medical Center, New York, describe a 32-year-old woman with progressive ALS-like motor neuron disease and newly diagnosed HIV infection with a CD4 count of 44/mm? Antiviral therapy led to complete and sustained recovery from motor neuron disease in conjunction with undetectable HIV RNA levels.
&nbps;&nbps;&nbps;&nbps;In an accompanying editorial, Dr. Jubelt notes that these seven cases of HIV-associated ALS syndromes differ from classic ALS in that the patients were younger than is typical, neurologic symptoms progressed "unusually rapidly," and the disorder improved with treatment.
&nbps;&nbps;&nbps;&nbps;Clearly more research is needed, Dr. Jubelt writes, but in the meantime, he recommends considering a viral cause in patients who present with signs of ALS., http://www.100md.com