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Remission of progressive multifocal leukoencephalopathy following highly active antiretroviral therapy in a patient with HIV infection.
Inui K; Miyagawa H; Sashihara J; Miyoshi H; Tanaka-Taya K; Nishigaki T;
December 30, 1999
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