Background and purpose

Middle-aged persons living with HIV (PLHIVs) experience heightened risk for more concomitant age-related comorbidities, acknowledged as signs of poorer deep-brain stimulation of the subthalamic nucleus (STN–DBS) prognosis, at younger-than-expected ages. To assess the beneficial and adverse effects of STN–DBS in PLHIVs with Parkinson’s disease (PD-PLHIVs).

Methods

We retrospectively included 9 PD-PLHIVs with sustained virological control. Patients were followed up to 7±4 years.

Results

Mean ages at PD onset and STN–DBS were, respectively, 45±15 and 53±16 years. At STN–DBS, respective mean HIV-infection and PD durations were 15±12, and 8±4 years. STN–DBS significantly improved 1-year UPDRS-III scores (71%), daily off-time (63%), motor fluctuations (75%) and daily levodopa-equivalent dose (68%); mean 5-year UPDRS-III score and motor-fluctuation improvements remained ~45%. Impulse-control disorders (affecting 6/9) fully resolved post-STN–DBS. Post-operative course was uneventful. No serious adverse events occurred during follow-up.

Conclusion

Our findings indicate that STN–DBS is a safe and effective treatment for PD-PLHIVs.