Pilot Study of Intravenous Immunoglobulin in HIV-Associated Myelopathy.

AIDS Patient Care STDS. 2009 Jan 27

Cikurel K, Schiff L, Simpson DM.

NeuroAIDS Research Program, Neurology Department, Mount Sinai Medical Center , New York, New York.

Abstract There is no effective treatment for HIV-associated myelopathy (HIVM). The introduction of highly active antiretroviral therapy (HAART) has made little difference to its natural history. Spinal cord pathology reveals vacuolization and inflammation. Intravenous immunoglobulin (IVIg) is used successfully in a number of inflammatory conditions associated with HIV. In view of the potential for reversibility of the inflammatory response in HIVM, we treated 17 patients with IVIg twice over a 56-day study period. There was improvement in composite Medical Research Council (MRC) strength scores 28 days following the first infusion (increase in score: 3.94; p = 0.021). The second infusion did not produce further improvement, however there was little reduction from peak strength. These pilot data suggest that further investigation of the use of IVIg in HIVM is warranted.