A comparative study of motor neuron disease in HIV-infected and HIV-uninfected patients

This study is a descriptive review of the clinical and treatment outcome differences in HIV-infected patients with motor neuron syndrome (MNS) and HIV-uninfected patients with motor neuron disease (MND).

A retrospective analysis of patients with MND/S was performed at Inkosi Albert Luthuli Central Hospital (IALCH), Durban, South Africa between 2003 and 2017.

One hundred and thirty six patients were included in the study, 101 (76%) were HIV-uninfected and 35 (26%) were HIV-infected. Ninety four percent of the HIV-infected cohort were <50 years, median 41, IQR (33-45), p < 0.001, had median ALS functional rating scale revised (ALSFRS-R) score of 28, IQR [24-30] and 40% of these patients on anti-retroviral therapy (ART) survived longer than 10 years. Ninety one percent of the HIV-uninfected cohort were >50 years, median 66, IQR(57-74), P < 0.001, had median ALSFRS-R score of 44 (IQR 42-45) and 93% died within 5 years of their illness.

HIV-infected MNS patients were younger, had more severe disease at presentation and survived longer if treated with ART with possible reversal of the disease process, compared to patients with MND.