HIV and multiple sclerosis (MS) are chronic conditions that, despite a massive amount of research, remain essentially incurable. The marked progress in treatment for these conditions has meant that both are now treatable, with the goal of treatment focussing on maintaining independence and quality of life. In the case of HIV, ensuring prolonged survival is an additional critical endpoint.
In JNNP online first, Gold and colleagues have presented an interesting study that explores the question of why patients with HIV never seem to get MS http://jnnp.bmj.com/content/early/2014/07/16/jnnp-2014-307932.abstract . As they mention in their report, there has only ever been one case reported of MS having developed in an HIV positive individual and that patient’s MS symptoms improved when treatment for HIV was commenced. The question raised in that report was whether there may be a virus linked to MS development that was being successfully treated with HIV medication. If so, could this be an avenue for future treatment?
In their study, Gold et al have undertaken a large cohort study using a British database. The major finding from their study is that HIV infection is associated with a lower risk of developing MS. They propose a number of different reasons for this association, including the fact that immunosuppression due to HIV infection may be reducing MS development. From a treatment perspective, the other possibility is that HIV treatments may also be reducing the impact of other viruses that are associated with the development of MS.
This is an interesting study that explores MS from a completely different angle. Well worth the read.