Multiple sclerosis and HIV: a case of multiple sclerosis-immune reconstitution inflammatory syndrome associated with antiretroviral therapy initiation

International Journal of STD & AIDS
Pria Anand, Deanna Saylor

Abstract

Studies have suggested that the incidence of multiple sclerosis (MS) in HIV-infected (HIV+) patients is lower than that of the general population. Here, we present a case of MS in an HIV+ patient with a relatively suppressed CD4 cell count who developed clinical and radiographic disease worsening in the setting of antiretroviral therapy (ART) initiation. A 47-year-old HIV+ woman (CD4 cell count 216 cells/µl) presented with decreased vision in her right eye. Magnetic resonance imaging (MRI) revealed optic nerve enhancement and open ring-enhancing lesions in the brain concerning for demyelinating disease. Cerebrospinal fluid was tested extensively for infection and malignancy with no abnormal findings. She received five days of intravenous methylprednisolone. Nine days later, she was restarted on ART. Three weeks later, she was readmitted with left eye vision loss and left hemiplegia (CD4 cell count 342 cells/µl). Repeat imaging showed multiple new enhancing lesions. Several cases have described severe MS relapses and unusually widespread demyelinating lesions on MRI after withdrawal of immunosuppressive drugs. We posit that the clinical and radiographic progression that occurred in our patient after initiation of ART represented...Continue Reading

References

Jan 1, 2006·Current Opinion in HIV and AIDS·Manuel Battegay, Henning Drechsler
Jul 28, 2010·Annals of Neurology·Joep KillesteinChris H Polman
Mar 10, 2011·Annals of Neurology·Chris H PolmanJerry S Wolinsky
Oct 4, 2011·Journal of Neurovirology·Alejandra González-DuarteJuan Sierra-Madero
Jun 20, 2012·Journal of Neuropathology and Experimental Neurology·B K Kleinschmidt-DeMastersTimothy Vollmer
Feb 5, 2013·Epidemiology·Bjørn Andersen NexøNils Koch-Henriksen
Aug 6, 2014·Journal of Neurology, Neurosurgery, and Psychiatry·Julian GoldMichael Goldacre
Nov 5, 2014·Journal of Neurovirology·Joshua Chalkley, Joseph R Berger
Mar 25, 2015·Journal of Neurovirology·Jerome H Chin

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Citations

Dec 31, 2019·BioMed Research International·Monika Gudowska-Sawczuk, Barbara Mroczko
Aug 20, 2019·Neurological Research and Practice·Maria-Ioanna StefanouMarkus C Kowarik
Jul 21, 2021·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·M P TopuzovaT M Alekseeva

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Methods Mentioned

BETA
flow cytometry

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