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Remission of progressive multifocal leukoencephalopathy following highly active antiretroviral therapy in a patient with HIV infection.


Brain Dev. 1999 Sep;21(6):416-9. Unique Identifier : AIDSLINE

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease resulting from lytic infection of oligodendrocytes by the papovavirus JC (JCV). PML has also been recognized as an AIDS-defining illness. The incidence of PML has increased since 1987 and it occurs in up to 4% of patients with AIDS. To date, there is no treatment available for PML and it usually results in death within 3-6 months of diagnosis. However, there are some reports of remission of PML after antiretroviral therapy. We report a 12-year-old child with hemophilia B and developing AIDS with the onset of PML. With highly active antiretroviral therapy, PML subsided with an increase of CD4 count from 10 to 300/microl in spite of about 1.0 X 10(4) human immunodeficiency virus (HIV)-1-RNA copies. He has survived more than 1 year without specific therapy against JCV. Highly active antiretroviral therapy appears to have improved his prognosis in HIV-associated PML.

JOURNAL ARTICLE Acquired Immunodeficiency Syndrome/COMPLICATIONS/*DRUG THERAPY/ PATHOLOGY Anti-HIV Agents/*THERAPEUTIC USE Brain/PATHOLOGY Case Report Child CD4 Lymphocyte Count Hemophilia B/COMPLICATIONS Human HIV Infections/COMPLICATIONS/*DRUG THERAPY/PATHOLOGY Leukoencephalopathy, Progressive Multifocal/*DRUG THERAPY/ ETIOLOGY/PATHOLOGY Magnetic Resonance Imaging Male Papovaviridae Infections/DRUG THERAPY/PATHOLOGY Polyomavirus hominis 2/GENETICS Reverse Transcriptase Polymerase Chain Reaction Ritonavir/THERAPEUTIC USE Zidovudine/THERAPEUTIC USE


Information in this article was accurate in December 30, 1999. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.