Link Between HIV and Multiple Sclerosis

A recent study presented in the Journal of Neurology, Neurosurgery and Psychiatry – recommends that people infected with HIV may be at much reduced risk of developing multiple sclerosis(MS).

The study team, which includes Prof. Julian Gold of The Albion Centre at the Prince of Wales Hospital states that if their results are proved, this could hold significant implications for the therapy of MS. Multiple sclerosis a disabling disease of the CNS.

Put together, there are over 1 million peer-reviewed research documenting HIV and MS. Of these, there has only ever been one case report of a person with both problems who was handled with HIV antiretroviral medicines. After 1 year of treatment, the individual’s MS symptoms vanished.

In this specific case report, Danish scientists hypothesized that antiretroviral treatment for HIV could be coincidentally treating MS or stopping its development. In this recent study, Prof. Gold and peers wanted to additional research this theory.

Individuals with HIV ‘63% less probably to develop multiple sclerosis’

The team reviewed data from English Hospital Episode Statistics in between 1999 and 2011, including 21,207 sufferers in England with HIV and more than 5 million controls.

For 7 years, all sufferers were supervised for progression of MS. The scientists measured the number of predicted MS cases among HIV sufferers and controls, and compared these statistics with the actual number of cases.

While in follow-up, there were 18 predicted MS cases among HIV sufferers and only 7 actual cases. Dependent on this, the team determined that individuals with HIV were 63% less probably to develop MS, in comparison with control patients.

In addition, the scientists identified that the possible safety effect of HIV against MS seems to be more powerful the more time that elapses between diagnosis of each situation.

Based on 16 predicted MS cases and 4 actual MS cases among sufferers who were clinically diagnosed with HIV over 1 year ago, the scientists measured that these sufferers were 75% less probably to develop MS. Those who were clinically diagnosed with HIV over 5 years ago were 85% less probably to develop MS, dependent on 6.5 expected cases of MS among these sufferers and only one actual case.

Prof. Gold and co-workers say their results are reliable with the theory earlier presented by the Danish researchers, but that this most recent research shows statistical relevance.

They stress, however, that these outcomes are simply observational and additional research are needed, but that they could hold significant implications for MS development and therapy if proved:

“If additional research shows there is a causal safety effect of HIV and/or its treatment and if the magnitude of it shows to be comparable this would be the most significant protective impact of any factor yet noticed in relation to the growth of MS.”

Why does HIV seem to secure against multiple sclerosis?

The study team highlights some concepts that may describe the observed safety effect of HIV towards MS.

For instance, they say that immunodeficiency activated by HIV, even without antiretroviral therapy, could protect against development of MS. “HIV affects immune cell homoeostasis and focuses on a wide range of immune cells and signaling path ways overlapping with MS pathogenesis,” they describe.

Additionally, they observe that antiretroviral medicines used to cure HIV may also control other pathogens connected to MS, for instance herpes viruses and human endogenous retroviruses (HERVs).

“If having HIV is connected with a significantly reduced risk of subsequent MS and the connection is in the causal chain, it is possibly because of some biological impact of HIV by itself on the pathogenesis of MS, or due to the fact the therapies for HIV are coincidentally also treating or avoiding development of MS,” the team says.

“However,” they add, “neither this research nor any study model that is possible at present can confirm which mechanism may be correct.”

They mention that their study is subject to a number of restrictions. For instance, they lacked information on how many people were subjected to antiretroviral therapy and the actual combo of drugs that were applied in such therapy, which could have affected the outcomes. They also note that they were missing data on the ethnicity of sufferers.

In an editorial connected to the research, Mia van der Kop, an epidemiologist at the University of British Columbia, notes that regardless of the restrictions of this research, the scientists have made an “important contribution” to past study indicating HIV may protect against MS.

“However, further study is needed to move over and above hypothesis generation,” she adds. “A reasonable next move would be to immediately examine the connection between exposure to antiretroviral treatment and the progression of MS.”

Stats Regarding Multiple Sclerosis

• Over 400,000 individuals in the United States suffering from this condition.
• More than 2,500,000 individuals have Multiple Sclerosis.
• More than 45 % of the individuals with MS are not seriously affected by the disease.
• Medical diagnosis of MS is generally between 20 and 40 years of age.
• Multiple Sclerosis impacts more females than males, with a rate of 2:1.
• Around 85 % of people who are recently diagnosed have the relapsing-remitting form of MS.
• Without disease-modifying treatment, about 50 % of those clinically diagnosed with relapsing-remitting MS will turn out to be progressive at 10 years.
• Without disease-modifying treatment, about 34% of those diagnosed with relapsing-remitting Multiple Sclerosis will be using a wheel chair at 20 years.