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Multiple sclerosis-like illness occurring with human immunodeficiency virus infection

Department of Neurology, University of Miami School of Medicine, Miami(Drs. Berger and Sheremata)
Department of Microbiology, University of Miami School of Medicine, Miami(Dr. Atherton)
Department of Internal Medicine, University of Miami School of Medicine, Miami (Drs. Berger and Fletcher)
Department of Pathology of the University of Miami School of Medicine, Miami (Dr. Norenberg)
Department of Dermatology, Mount Sinai Hospital, Miami Beach, FL. (Dr. Resnick)

We describe seven men with a neurologic disease clinically indistinguishable from multiple sclerosis occurring in association with seropositivity for the human immunodeficiency virus, type 1 (HIV-1). Histopathology of the CNS obtained in three patients (2 by brain biopsy, 1 at autopsy) was consistent with MS. The neurologic symptoms preceded the onset of clinically evident immunosuppression in all patients. In three men, HIV-1 seropositivity was demonstrated concomitantly or within 3 months of the onset of their neurologic disease. In the others, features of MS preceded the demonstration of HIV-1 seropositivity by 41 months, 59 months, 11 years, and 18 years, respectively. Despite the superimposition of varying degrees of cellular immunodeficiency associated with HIV-1 infection, six of these men continued to experience relapsing neurologic symptoms.

Address correspondence and reprint requests to Dr. Berger, Department of Neurology, University of Miami School of Medicine, 1501 NW 9th Avenue, Miami, FL 33136.

Supported in part by grant NS 25569–01 from the National Institutes of Health.

Presented in part at the IVth International Conference on AIDS, Stockholm, Sweden, June 13, 1988.

Received July 13, 1988. Accepted for publication in final form September 7, 1988.

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