Parkinsonism in hiv-infected patients on highly active antiretroviral therapy.

摘要

Highly active antiretroviral therapy (HAART) has significantly prolonged the lives of HIV-infected patients but low level chronic immune activation remains in some. Neurodegenerative diseases are often associated with immune activation which likely plays a role in their pathogenesis. Recently, increased alpha-synuclein deposition in the substantia nigra in aging HIV-infected patients has been identified, although there was no clear clinical correlate. These observations suggest that HIV and HAART may facilitate the development of neurodegenera-tion and accelerate the appearance of diseases such as Parkinson disease (PD) via mechanisms including inflarnmation, mitochondrial dysfunction, and interference with the ubiquitin proteasome pathway. Here we describe 3 patients with relatively young onset of parkinsonism in the context of HIV and HAART.