Does HIV Infection Alter Parkinson Disease?

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• Idiopathic Parkinson disease (PD) affects dopaminergic neurons.
• Human Immunodeficiency Virus (HIV) infection impacts the central nervous system.
• Understanding PD in HIV-positive individuals is crucial for comprehensive care.

Purpose of the Study:

• To characterize clinical features, treatments, and outcomes of HIV-infected patients with PD.
• To compare PD in persons living with HIV (PLH) to an HIV-negative cohort.
• To assess the impact of sustained HIV suppression on PD progression.

Main Methods:

• Retrospective, single-center, matched case-control study (1:2 ratio).
• Included 15 HIV-infected patients with PD and 9847 persons living with HIV (PLH) over 12 years (2002-2013).
• Compared PD clinical features, dopamine replacement therapy (DRT), and HIV data.

Main Results:

• PD prevalence in PLH was similar to the general population.
• Clinical presentation and initial treatment were comparable between HIV-positive and HIV-negative PD patients.
• HIV-positive PD patients showed significantly better motor scores and functional status at follow-up despite similar DRT.
• Deep brain stimulation was successful in one HIV-positive patient.

Conclusions:

• HIV-associated PD shares similarities with idiopathic PD.
• HIV may induce functional adaptation in dopaminergic neurons, potentially counterbalancing PD-related neurodegeneration.
• Concurrent HIV infection does not negatively impact the outcome of idiopathic PD.