Objective: About 12 million people in the world suffer from Parkinson’s disease (PD), and 36.9 million suffer from HIV. The proportion of people with HIV older than 50 y.o. is 42%. Given the data of epidemiology, the problem of combination of PD and HIV is relevant.

Background: Patient I., 55 y.o., considers herself ill since 2007 (47 years), when pain and restriction of movements in the left shoulder joint appeared, after 2 years developed stiffness of the left leg.

Method: Since 2011 she administers levodopa. In 2015 mild dystonia of the left leg developed, until 2016 the disease had a moderate rate of progression, by the end of 2015 the PD stage was 2.0 by Hoehn and Yahr scale. In 2016, she suffered a 3-days episode of an acute increase of the body temperature up to 390Сwithout any inflammation symptoms. After this episode the progression of PD has accelerated with appearance of acute deterioration in motor activity, dyskinesias, increased dystonia, gait instability, in mid-2016, the stage of PD became 2.5 by Hoehn and Yahr scale. In 2017 she was diagnosed as HIV carrier, started ARVT (Zidolam 0.3 + 0.6 g / day, Isentress 0.8 g / day), and it appeared that symptoms of PD worsened: painful muscle spasms developed, dystonia increased, gait significantly worsened, rigidity, hypokinesia, motor fluctuations increased, in the form of abrupt transitions from «on» to «off» to 4 min, «delayed on-periods» to 40 min, the effect of «dose skipping». In the «off-period» PD stage reached 3.0 by Hoehn and Yahr scale. Due to the ineffectiveness of ARVT (high viral load remained) in the autumn of 2018 it was corrected (Emtritab 0.2 g / day, Tenofovirum 0.3 g / day, Isentress 0.8 g / day), and again dystonia significantly increased, painful spasms appeared in areas of the left ankle, the patient began to use a wheelchair. In February 2019 PD stage in the «off-period» became 4.0 by Hoehn and Yahr scale.

Results: A feature of the presented clinical case is that the patient is cognitively conserved (MMSE-28, MoCA – 30, 2019), brain MRI data from 2019 exclude the development of neurological complications of HIV.

Conclusion: Thus, we observed the rapid progression of PD on the background of HIV and the effect of ARVT on the severity of dystonia, i.e. patients with this combination need a personalized approach to treatment of PD and HIV.

« Back to 2019 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/the-impact-of-hiv-on-the-severity-and-course-of-parkinsons-disease-a-clinical-case/