HIV-associated motor neuron disease: HERV-K activation and response to antiretroviral therapy. (25th October 2016)

• Record Type: Journal Article
• Authors: Bowen, Lauren N.; Tyagi, Richa; Li, Wenxue; Alfahad, Tariq; Smith, Bryan; Wright, Mary; Singer, Elyse J.; Nath, Avindra
• Is Part Of: Neurology. Volume 87:Number 17(2016)
• Publication Date: 2016-10-25
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000003258
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : Objective: To determine whether there is activation of human endogenous retrovirus K (HERV-K) in amyotrophic lateral sclerosis in HIV infection and whether it might respond to treatment with antiretroviral drugs. Methods: In this case series, we present 5 patients with HIV infection who subsequently developed motor neuron disease involving both upper and lower motor neurons. We monitored HERV-K levels in plasma of 4 of these patients. Results: Three patients who received antiretroviral therapy had reversal of symptoms within 6 months of onset of neurologic symptoms and the other 2 had slow neurologic progression over several years. Three patients in whom the levels were measured at onset of neurologic symptoms showed elevated HERV-K levels that responded to optimization of antiretroviral therapy for CNS penetration. Conclusions: Thus, motor neuron disease in individuals with HIV infection may a treatable entity, but early treatment with CNS-penetrating antiretroviral therapy may be necessary. Monitoring of HERV-K levels may help guide treatment.