Remission of progressive multifocal leukoencephalopathy following highly active antiretroviral therapy in a patient with HIV infection.
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.
Inui
K
K
Department of Pediatrics, Faculty of Medicine, Osaka University, Suita, Japan.
Miyagawa
H
H
Sashihara
J
J
Miyoshi
H
H
Tanaka-Taya
K
K
Nishigaki
T
T
Teraoka
S
S
Mano
T
T
Ono
J
J
Okada
S
S
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology; D018791:CD4 Lymphocyte Count; D002648:Child; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D002836:Hemophilia B / Q000150:complications; D006801:Humans; D007577:JC Virus / Q000235:genetics; D007968:Leukoencephalopathy, Progressive Multifocal / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D030361:Papillomavirus Infections / Q000188:drug therapy / Q000473:pathology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D019438:Ritonavir / Q000627:therapeutic use; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D015215:Zidovudine; D019438:Ritonavir