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Amyotrophic lateral sclerosis (ALS) (also referred to as motor neuron disease [MND]) is characterized clinically by progressive weakness of limb, bulbar, and respiratory muscles. Clinically definite ALS is characterized by the presence of mixed upper and lower motor neuron deficits in three or more anatomic areas. Patients with isolated upper motor neuron disorder (primary lateral sclerosis [PLS]) or lower motor neuron disorder (progressive muscular atrophy [PMA]) exhibit a relatively benign clinical course compared to that in classic ALS.
A viral etiology of ALS has been hypothesized for over four decades. Retroviral hypothesis of MND is particularly attractive because retroviruses replicate by synthesizing and integrating a DNA copy that persists into the host genome.
HIV type 1 (henceforth called HIV)–associated ALS or PMA have been previously reported.1–5 We describe HIV-associated PLS in two patients.
Case reports.
Case 1.
A 57-year-old man was first hospitalized for Pneumocystis carinii pneumonia in December 2001. Laboratory testing revealed that he was HIV seropositive by enzyme-linked immunosorbent assay and Western blot analysis. In early 2004, he …
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