Department of Neurology, St. John's Medical College Hospital, Sarjapura Road, Bengaluru, Karnataka 560034, India.
Department of Neurology, St. John's Medical College Hospital, Sarjapura Road, Bengaluru, Karnataka 560034, India.
Mult Scler Relat Disord. 2019 Jan;27:289-293. doi: 10.1016/j.msard.2018.11.014. Epub 2018 Nov 13.
HIV Infection associated NMOSD (HIV-NMOSD) is a recently recognized entity. Management of patients with HIV-NMOSD is a challenge. Here we report our own experience of HIV-NMOSD along with a complete review of all the cases of HIV-NMOSD reported in literature.
Describe the clinical features, radiological findings, treatment patterns and outcomes in patients with HIV-NMOSD.
The details of all cases of HIV- NMOSD were searched from our NMOSD registry. A literature search was also done using the terms NMO, NMOSD and HIV infection in PUBMED, Google Scholar and EMBASE. The details of all the reported cases and cases from our registry were collected and analyzed.
Six cases of HIV-NMOSD were identified from the literature and one from our registry. There were four males and three females with age ranging from 8 years to 49 years. Duration of HIV infection ranged from newly detected to 15 years. Optic neuritis followed by myelitis was the commonest presentation, occurring in 5 out of 7 patients. 3 patients were anti-aquaporin 4 antibody positive while 3 were negative and in one anti- aquaporin 4 antibody assay was not done. All patients received immunomodulatory treatment. 5/7 patients had poor recovery from acute attacks but no patient had further relapses while on immunomodulatory treatment and antiretroviral therapy.
HIV associated NMOSD is a recently recognized entity. A high index of suspicion is needed to diagnose these patients. In all patients with HIV infection presenting with optic neuritis or/and myelitis, anti aquaporin 4 antibody status should be checked and in all patients of NMOSD, HIV infection should be ruled out.
HIV 感染相关的 NMOSD（HIV-NMOSD）是一种新认识的疾病实体。HIV-NMOSD 患者的管理颇具挑战。在此，我们报告了自身的 HIV-NMOSD 诊疗经验，并对文献中所有 HIV-NMOSD 病例进行了全面回顾。
描述 HIV-NMOSD 患者的临床特征、影像学发现、治疗模式和结局。
从我们的 NMOSD 登记处搜索所有 HIV-NMOSD 病例的详细信息。还通过在 PUBMED、Google Scholar 和 EMBASE 中使用 NMO、NMOSD 和 HIV 感染等术语进行了文献检索。收集并分析了所有报告病例和我们登记处病例的详细信息。
从文献中确定了 6 例 HIV-NMOSD 病例和 1 例来自我们登记处的病例。患者中男性 4 例，女性 3 例，年龄 8-49 岁。HIV 感染持续时间从新发现到 15 年不等。视神经炎继之出现脊髓炎是最常见的表现，7 例患者中有 5 例出现该表现。3 例患者抗水通道蛋白 4 抗体阳性，3 例为阴性，1 例未进行抗水通道蛋白 4 抗体检测。所有患者均接受免疫调节治疗。5/7 例患者急性发作后恢复不佳，但在免疫调节治疗和抗逆转录病毒治疗期间，没有患者进一步复发。
HIV 相关 NMOSD 是一种新认识的疾病实体。诊断这些患者需要高度怀疑。对于所有出现视神经炎或/和脊髓炎的 HIV 感染患者，应检查抗水通道蛋白 4 抗体状态，对于所有 NMOSD 患者，应排除 HIV 感染。
