Human Immunodeficiency Virus and Multiple Sclerosis Risk: Probing for a Connection

Abstract

Multiple Sclerosis (MS) is a chronic autoimmune inflammatory disease of the nervous system, with intense genetic and environmental background. Its etiology is poorly understood and likely multifactorial but its epidemiology has been intensively studied. This complex disease displays heterogeneity in terms of geographic and genetic influences on incidence, insinuating an effect of local unknown environmental factors on its development. Among numerous potential factors putatively involved in the etiopathogenesis of MS, retroviruses appear to influence MS. The intent of this review is to highlight the association between human immunodeficiency virus (HIV) and the risk of developing MS while at the same time providing an overview of the insights gleaned from different studies. HIV infection is associated with a reduced risk of MS development, and perhaps, appears to be another wedge of the MS conundrum. The probable mechanisms for this relationship may be suppression of the immune system and/or antiretroviral drug therapy. While highlighting the relevance of antiretroviral medications as potential future alternatives for the effective treatment of MS, this review provides an impetus for further studies. We conclude that studies in this milieu hitherto are insufficient, and there is need for an upsurge in molecular epidemiological and clinical studies, with focus on the mechanism behind the impact of HIV/antiretroviral drugs on MS. Such inquiry could precisely establish the causes for associations between HIV and MS, perhaps impacting treatment options for both.

Is there a Low Risk of Multiple Sclerosis in HIV Patients?

“…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].…”

“…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 this case ART could affect other retroviruses postulated in the pathophysiology of MS. Currently there are MS investigations involving the experimental use of antiretrovirals such as raltegravir and the monoclonal antibody GNbAC1 used against HERVs [2].…”

“…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.…”

Serum Evaluation of Human T-lymphotropic Virus Type 1 and 2 (HTLV-I/II) and Human Immunodeficiency Virus (HIV) in Patients with Multiple Sclerosis (MS)

“…It is becoming more common and widespread in developed and developing countries (2,3). Its prevalence is much higher in women and people between 20 and 40 years old (4). Multiple genes (5,6) and various well-defined environmental factors, such as vitamin D (7)(8)(9) or ultraviolet light exposure (10)(11)(12), smoking (13)(14)(15), obesity, and Epstein-Barr virus infection, potentially contribute to susceptibility to this multifactorial disease (16).…”