title: Deep Brain Stimulation of the Subthalamic Nucleus for Parkinson's Disease in a Patient with HIV Infection: Dual Clinical Benefit.
abstract: As a result of the efficacy of highly active antiretroviral therapy (HAART), patients with human immunodeficiency virus (HIV) can survive longer and are thus naturally prone to ageing-related degenerative disorders such as Parkinson's disease (PD). Managing PD and HIV in the same patient may be challenging, as HAART and levodopa interact and may cause intolerable side effects. Concerns about the increased risk of hardware infection in immunocompromised patients submitted to deep brain stimulation of the subthalamic nucleus (STN-DBS) still persist. We report a PD patient with HIV infection who suffered peak-dose dyskinesias and intolerable gastrointestinal side effects while on HAART, prompting its suspension. STN-DBS allowed complete postoperative levodopa withdrawal and HAART restart, without infectious complications after 12 months of follow-up. STN-DBS seems to be a safe procedure in selected patients with both medically refractory PD and HIV infection, and may result in clinical optimization of both conditions.
authors: Department of Neurology, Centro Hospitalar do Alto Alve, EPE, Guimarães, Porto, Portugal.
authors: Miguel F
authors: MF
authors: Gago
authors: Maria José
authors: MJ
authors: Rosas
authors: Paulo
authors: P
authors: Linhares
authors: João
authors: J
authors: Massano
authors: António
authors: A
authors: Sarmento
authors: Rui
authors: R
authors: Vaz