Lou Gehrig's Symptoms Seen in People with HIV

Two teams of scientists report that HIV may trigger cases of a neurological disorder similar to amyothropic lateral sclerosis (ALS), also known as Lou Gehrig's disease. But unlike normal ALS, which is always fatal, symptoms of the HIV-related neurological disorder stopped progressing or improved once patients began therapy to treat HIV. The two studies are reported in the current issue of Neurology (September 25, 2001;57:945-946, 995-1001 and 1094-1097).

In a review of 1,700 HIV patients treated during a 13-year period, French researcher Dr. Antoine Moulignier of the Foundation Adolphe de Rothschild in Paris, and his colleagues, identified six individuals who showed signs of an ALS-like disease. The percentage of patients who had this disorder was considerably higher than the percentage of the general population that has ALS. Other findings included a more rapid progression of symptoms, occurring over a few weeks, than is found in ALS, younger patients -- average age of HIV-positive patients was 34 years, compared to the typical ALS patients who are commonly between 55 and 60 when the disease strikes. Finally, unlike ordinary ALS, which remains untreatable, the HIV-related ALS-like symptoms improved in some patients after they began taking AIDS drugs.

In a second report, Dr. Daniel J.L. MacGowan of Beth Israel Medical Center in New York and colleagues document a case of a 32-year-old HIV-positive woman who developed an ALS-like syndrome. Once the woman began taking combination antiretroviral therapy, including a protease inhibitor, her ALS-like symptoms disappeared within a year. Four years after starting treatment, the woman remains free of ALS-like symptoms.

In an editorial accompanying the new reports, Dr. Burk Jubelt of the State University of New York Upstate Medical University at Syracuse wrote, "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." According to Jubelt and his co-author, Dr. Joseph R. Berger of the University of Kentucky Medical Center in Lexington, "when a patient presents with the classic clinical signs of ALS, a viral cause should also be considered because HIV-ALS syndromes are treatable."

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