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Friday, January 23, 2015

Leave No Stone Unturned: AIDS; MULTIPLE SCLEROSIS

Exploring the relationship between HIV and MS Having HIV, and presumably being on antiretroviral therapy, may reduce the risk of developing MS Last updated: 20th January 2015 Although the cause of MS is still unknown, several studies have suggested that an infectious agent, like a virus, may be involved. However researchers have not been able to identify a single virus as the trigger for MS.

Even though MS and HIV infection are two of the most documented conditions in clinical medicine, there is only one reported case of a patient with both MS and HIV. In this case, the patient’s MS symptoms resolved completely after starting antiretroviral therapy and remained so for more than 12 years of follow-up. As the pathogenesis of MS has been linked to several viruses, antiretroviral therapy for HIV may coincidentally treat or prevent progression of MS. Hypothesis To test this hypothesis, a group of researchers in England used one of the world’s largest linked medical data sets to study the relationship between HIV and developing MS. The total number of people with HIV in this study was 21,207 and the follow-up period was about seven years. The researchers found a negative association between HIV and MS – meaning that having HIV, and presumably being on antiretroviral therapy, reduced the risk of developing MS. However, there are several possible explanations for these findings. The next step might be to carry out other studies on the use of antiretroviral drugs in patients with different types of MS. The first clinical study with Raltegravir, an antiretroviral drug used to treat HIV infection, is already recruiting relapsing-remitting MS patients in the UK.

Read the full article Page Tags: United Kingdom - See more at: http://www.msif.org/news/2015/01/19/exploring-relationship-hiv-ms/#sthash.kWDVrdXe.dpuf



Exploring the relationship between HIV and MS

As the pathogenesis of MS has been linked to several viruses, antiretroviral therapy for HIV may coincidentally treat or prevent progression of MS.
 
2015 Jan;86(1):9-12. doi: 10.1136/jnnp-2014-307932. Epub 2014 Aug 4.

HIV and lower risk of multiple sclerosis: beginning to unravel a mystery using a record-linked database study.

Abstract

OBJECTIVES:

Even though multiple sclerosis (MS) and HIV infection are well-documented conditions in clinical medicine, there is only a single case report of a patient with MS and HIV treated with HIV antiretroviral therapies.

In this report, the patient's MS symptoms resolved completely after starting combination antiretroviral therapy and remain subsided for more than 12 years.

Authors hypothesised that because the pathogenesis of MS has been linked to human endogenous retroviruses, antiretroviral therapy for HIV may be coincidentally treating or preventing progression of MS.

This led researchers from Denmark to conduct an epidemiological study on the incidence of MS in a newly diagnosed HIV population (5018 HIV cases compared with 50 149 controls followed for 31 875 and 393 871 person-years, respectively). The incidence rate ratio for an HIV patient acquiring MS was low at 0.3 (95% CI 0.04 to 2.20) but did not reach statistical significance possibly due to the relatively small numbers in both groups. Our study was designed to further investigate the possible association between HIV and MS.

METHODS:

We conducted a comparative cohort study accessing one of the world's largest linked medical data sets with a cohort of 21 207 HIV-positive patients and 5 298 496 controls stratified by age, sex, year of first hospital admission, region of residence and socioeconomic status and 'followed up' by record linkage.

RESULTS:

Overall, the rate ratio of developing MS in people with HIV, relative to those without HIV, was 0.38 (95% CI 0.15 to 0.79).

CONCLUSIONS:

HIV infection is associated with a significantly decreased risk of developing MS. Mechanisms of this observed possibly protective association may include immunosuppression induced by chronic HIV infection and antiretroviral medications.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

KEYWORDS:

AIDS; MULTIPLE SCLEROSIS
PMID:
25091370
[PubMed - in process]


PMCID:
PMC4283699
 

Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=Gold+J+et+al%2C++J+Neurol+Neurosurg+Psychiatry%2C+2015%3B+86%3A9-12




 

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