Home Health & Wellness Study Shows Lower Risk of Multiple Sclerosis in People Living with HIV

Study Shows Lower Risk of Multiple Sclerosis in People Living with HIV

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A recent international study has found that individuals living with HIV have a lower risk of developing multiple sclerosis (MS) compared to the general population. The study, published in the Annals of Neurology, provides important insights into the relationship between HIV, antiretroviral therapy (ART), and MS.

The research analysed population-based health data from Sweden and British Columbia, Canada. The objective was to compare the risk of MS in people living with HIV to that in the general population and to explore whether ART exposure influences this risk.

The study involved two large cohorts: the Swedish InfCareHIV cohort and the Comparative Outcomes And Service Utilization Trends (COAST) cohort from British Columbia. Data included HIV diagnosis dates, ART exposure dates, and MS diagnosis dates. The researchers tracked individuals from one year after their HIV diagnosis until the earliest occurrence of MS, emigration, death, or the study end date (March 31, 2020, in Canada and December 31, 2018, in Sweden).

The combined cohort included 29,163 individuals (75% men), with a total follow-up time of 242,248 person-years. The incidence of MS in the HIV-positive cohort was compared to the expected incidence in the general population, adjusted for age, sex, calendar year, socioeconomic status (SES), and region of birth.

During the follow-up period, 14 cases of MS were observed among the HIV-positive individuals, whereas 26.19 cases were expected based on general population rates. This resulted in a standardised incidence ratio (SIR) of 0.53, indicating a significantly lower risk of MS among people living with HIV. The SIR for MS following the first exposure to ART was similarly low at 0.55.

Notably, the reduced risk of MS was more pronounced in women (SIR = 0.28) than in men (SIR = 0.70). The study found minimal difference in MS risk before and after ART exposure, suggesting that HIV infection itself, rather than ART, might confer some protective effect against MS.

These findings support the hypothesis that HIV infection, and potentially ART, may reduce the risk of developing MS. HIV leads to a progressive loss of CD4+ T cells and an increase in pro-inflammatory cytokines, which could potentially modulate the immune response implicated in MS. However, the exact mechanisms remain unclear and warrant further investigation.

The study’s results align with previous research from England, which also reported a lower incidence of MS among individuals with HIV. However, studies from Denmark and Taiwan did not find significant associations, likely due to limited sample sizes and differences in population demographics.

The research offers promising avenues for understanding the etiology and pathogenesis of MS. If HIV or ART can indeed alter MS risk, this could lead to novel therapeutic approaches for MS, leveraging mechanisms used in HIV treatment. Furthermore, understanding how HIV and ART interact with the immune system may provide broader insights into autoimmune diseases and their management.

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