title: Clinical course and prognostic factors of progressive multifocal leukoencephalopathy in patients treated with highly active antiretroviral therapy.
abstract: We analyzed survival rates, neurologic function, and prognostic factors for 118 consecutive patients with acquired immunodeficiency syndrome-associated progressive multifocal leukoencephalopathy (PML) treated with highly active antiretroviral therapy (HAART) in 11 hospitals throughout Spain. Seventy-five patients (63.6%) remained alive for a median of 114 weeks (2.2 years) after diagnosis of PML. Neurologic function of the survivors was categorized as cure or improvement in 33, stabilization or worsening in 40, and unknown in 2. The baseline CD4+ cell count was the only variable found with prognostic significance. The odds ratio of death was 2.71 (95% confidence interval, 1.19-6.15) for patients with CD4+ cell counts of <100 cells/microL, compared with patients who had CD4+ cell counts of > or =100 cells/microL. One-third of patients with PML died despite receipt of HAART; neurologic function improved in approximately one-half of the survivors. A CD4+ cell count of <100 cells/microL was associated with higher mortality.
authors.affiliation: Infectious Diseases Service of Hospital Gregorio Marañón, 28007, Madrid, Spain. juaberber@terra.es
authors.forename: Juan
authors.initials: J
authors.lastname: Berenguer
authors.forename: Pilar
authors.initials: P
authors.lastname: Miralles
authors.forename: Julio
authors.initials: J
authors.lastname: Arrizabalaga
authors.forename: Esteban
authors.initials: E
authors.lastname: Ribera
authors.forename: Fernando
authors.initials: F
authors.lastname: Dronda
authors.forename: Josu
authors.initials: J
authors.lastname: Baraia-Etxaburu
authors.forename: Pere
authors.initials: P
authors.lastname: Domingo
authors.forename: Manuel
authors.initials: M
authors.lastname: Márquez
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Rodriguez-Arrondo
authors.forename: Fernando
authors.initials: F
authors.lastname: Laguna
authors.forename: Rafael
authors.initials: R
authors.lastname: Rubio
authors.forename: José
authors.initials: J
authors.lastname: Lacruz Rodrigo
authors.forename: J
authors.initials: J
authors.lastname: Mallolas
authors.forename: Verónica
authors.initials: V
authors.lastname: de Miguel
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D011379:Prognosis