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Published on: October 6, 2016
A review of movement disorders in persons living with HIV
Ferzana Amod1, Vikram V Holla2, Rajeev Ojha3
1Department of Neurology, University of KwaZulu-Natal, South Africa.
Background:
The human immunodeficiency virus (HIV) causes movement disorders in persons living with HIV (PLH).
Objectives And Methods:
We conducted a systematic review on the spectrum of movement disorders in PLH using standard terms for each of the phenomenologies and HIV.
Results:
Movement disorders in PLH were commonly attributed to opportunistic infections (OI), dopamine receptor blockade reactions, HIV-associated dementia (HAD), presented during seroconversion, developed due to drug reactions or antiretroviral therapy (ART) itself and lastly, movement disorders occurred as a consequence of the HIV-virus. Parkinsonism in ART naïve PLH was associated with shorter survival, however when Parkinsonism presented in PLH on ART, the syndrome was indistinguishable from Idiopathic Parkinson's disease and responded to therapy. Tremor was often postural due to HAD, drugs or OI. Generalized chorea was most frequent in HIV encephalopathy and toxoplasmosis gondii caused most cases of hemichorea. Ataxia was strongly associated with JCV infection, ART efavirenz toxicity or due to HIV itself. Dystonia was reported in HAD, secondary to drugs and atypical facial dystonias. Both cortical/subcortical and segmental/spinal origin myoclonus were noted mainly associated with HAD. In patients with HIV related opsoclonus-myoclonus-ataxia-syndrome, seroconversion illness was the commonest cause of followed by IRIS and CSF HIV viral escape phenomenon.
Conclusions:
Aetiology of movement disorders in PLH depend on the treatment state. Untreated, PLH are prone to develop OI and HAD and movement disorders. However, as the number of PLH on ART increase and survive longer, the frequency of ART and non-AIDS related complications are likely to increase.
Insights
Human immunodeficiency virus (HIV) can cause various movement disorders in people living with HIV (PLH). These disorders stem from opportunistic infections, HIV-associated dementia, and treatments like antiretroviral therapy (ART).
Area of Science:
- Neurology
- Infectious Diseases
- Movement Disorders
Background:
- Human immunodeficiency virus (HIV) is known to cause a range of movement disorders in affected individuals.
- Understanding these neurological complications is crucial for managing the health of people living with HIV (PLH).
Conclusions:
- The etiology of movement disorders in PLH is influenced by their treatment status.
- Untreated PLH are susceptible to opportunistic infections and HAD, leading to movement disorders.
- With increased ART use and longer survival, non-AIDS and ART-related complications, including movement disorders, are becoming more prevalent.
