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Progressive multifocal leukoencephalopathy in patients with AIDS receiving highly active antiretroviral therapy.
Tantisiriwat W; Tebas P; Clifford DB; Powderly WG; Fichtenbaum CJ;
December 30, 1999
Clin Infect Dis. 1999 May;28(5):1152-4. Unique Identifier : AIDSLINE

Recent reports suggest that human immunodeficiency virus (HIV)-associated progressive multifocal leukoencephalopathy (PML) may improve with highly active antiretroviral therapy (HAART). We observed three patients who developed PML while receiving HAART. All patients received HAART for 4-11 months and had low plasma levels of HIV-1 RNA before the onset of symptoms of PML. Antiretroviral therapy was changed in two patients, and their plasma HIV-1 RNA levels declined significantly. Despite this virologic response, PML did not improve in these patients. The third patient's HIV-1 RNA level became undetectable while he was receiving HAART, and his symptoms of PML improved after the addition of interferon alpha. Our observations suggest that PML can develop in patients who have shown clinical response to HAART. Furthermore, PML may not improve despite an adequate virologic response to HAART. Definitive therapy is still needed for PML.

JOURNAL ARTICLE Acquired Immunodeficiency Syndrome/COMPLICATIONS/*DRUG THERAPY Anti-HIV Agents/*THERAPEUTIC USE *AIDS-Related Opportunistic Infections/VIROLOGY Case Report Drug Therapy, Combination Fatal Outcome Human HIV Protease Inhibitors/*THERAPEUTIC USE HIV-1/*ISOLATION & PURIF *Leukoencephalopathy, Progressive Multifocal/ETIOLOGY/VIROLOGY Male Middle Age RNA, Viral/BLOOD

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