Is there a Low Risk of Multiple Sclerosis in HIV Patients?
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 4, Issue 2
Abstract
Objective: Discuss the hypothesis of HIV infection to reduce the risk of Multiple Sclerosis. Method: Non-systematic review using a Google Scholar platform of articles with the keywords: “HIV” or “Human Immunodeficiency Virus” associated with the term “multiple sclerosis” in the title of the journal. Results and Discussion: 44 articles were used in English language for this manuscript. Conclusion: Rarely antibiotics may cause seizures, mainly in patients with renal dysfunction, hepatic or previous brain disease. It is important to learn about drugs at greatest risk of seizures in each class of antibiotics. The treatment involves the use of correct medications, primarilygabaergic drugs, avoiding ineffective anticonvulsants. Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) of an autoimmune nature with lymphocyte involvement. Activated lymphocytes cross the bloodbrain barrier and cause demyelination and axonal loss [1,2]. The disease affects 2.5 million people worldwide. It has a predominance in females and a higher incidence in people between 20 and 40 years of age [2]. This distribution of age and sex is also observed in samples of the Brazilian population [3]. Multiple sclerosis (MS) is the leading non-traumatic incapacitating neurological disease in young people economically active [4]. It can be subdivided into 4 clinical subtypes: the most frequent remission form, secondarily progressive form, primarily progressive and benign form [5]. Immunopathological findings include the predominant activation of CD8+ T lymphocytes on other T and B lymphocyte subpopulations, including CD4+ lymphocytes. The diagnosis is essentially clinical with widespread signs and symptoms in space and time with imaging studies demonstrating the presence of white matter lesions [1]. On the other hand, HIV infection (Human Immunodeficiency Virus) affects about 34 million people worldwide [6]. The HIV virus is subdivided into types I and II. Type I was discovered in a French patient in the year 1983 and the type II in Africa in 1986 [7]. Data from 2010 estimated about 620 thousand people infected with HIV in Brazil. The infection predominates in the age range between 20 and 40 years in males and 30 to 50 years in females [8]. Both MS and HIV infection are examples of immune diseases where there is a change in the inflammatory response of CD4+ T and CD8+ T lymphocytes. In addition, we observed a higher incidence of these diseases in similar age groups. Despite this, there are few reported cases of patients affected by both diseases [9]. The risk of multiple sclerosis in HIV patients could be up to 62% lower when compared to the general population [2]. In addition, both diseases have opposite gender prevalence, with MS being more prevalent in women and HIV in men [10]. In addition, in sub-Saharan Africa where there is a higher rate of HIV infection, there is a lower risk of MS compared to the United States and Europe [11]. On the other hand, many of the reported cases of individuals with both diseases could represent a diagnostic error because they predate the 1990s. At that time, the current clinical, laboratory and imaging criteria for the diagnosis of MS were not used yet [12,13]. Research on cases involving both diseases may increase understanding about the functioning of the immune system in the various inflammatory diseases of the CNS.
Authors and Affiliations
Celmir De Oliveira Vilaca, Marco Antonio Araujo Leite, Rossano Fiorelli, Pietro Novelino, Ricardo Martelo, Marco Orsini
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