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Cardiac sympathetic denervation, detectable via 123 I-MIBG scintigraphy, is strongly associated with disease progression ( Management complications: Cardiovascular symptoms complicate pharmacotherapy by interacting with anti-parkinsonian drugs that modulate autonomic tone, requiring dose balancing and often necessitating cardiology consultation ( 4.3 HIV co-infection and antiretroviral therapy HIV-positive individuals are at increased risk of parkinsonism due to basal ganglia vulnerability to viral neurotoxicity, chronic inflammation, and mitochondrial stress (Denaro et al., 2022

The delayed disease has features resembling those of mucosal disease of cattle, which is considered to be caused by superinfection by a different strain of BVDV or by minor mutation of homologous virus in animals that are persistently infected

Mar Drugs 2021