title: Treatment options for progressive multifocal leukoencephalopathy in HIV-infected persons: current status and future directions.
abstract: Progressive multifocal encephalopathy (PML) caused by JC virus was frequently encountered in AIDS patients before combination antiretroviral therapy (cART). Incidence decreased and the outcome improved with cART. The immune reconstitution with cART is beneficial for HIV-infected patients and is an effective treatment for PML. However, when it is excessive an inflammatory response immune syndrome might occur with deterioration of PML. So far, no specific therapy has proven efficacious in small clinical trials in spite of some optimistic case reports. Combination of drugs targeted at different stages of JC virus life cycle seems to have a better effect. Passive and active immune therapies, immune competence "boosters" appear promising. New future approaches such as gene editing are not far away.
authors.affiliation: a Department of Microbiology, Immunology and Infectious Diseases , University of Montreal, Succursale Centre Ville , Montreal , Quebec , Canada.
authors.forename: Maude
authors.initials: M
authors.lastname: Loignon
authors.affiliation: a Department of Microbiology, Immunology and Infectious Diseases , University of Montreal, Succursale Centre Ville , Montreal , Quebec , Canada.|b Département de microbiologie et maladies infectieuses , Hôtel-Dieu Hospital du Centre Hospitalier de l'Université de Montréal (CHUM) , Montreal , Quebec , Canada.
authors.forename: Emil
authors.initials: E
authors.lastname: Toma
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D000998:Antiviral Agents / Q000627:therapeutic use*; D000077404:Cidofovir; D060085:Coinfection; D003561:Cytarabine / Q000627:therapeutic use; D003596:Cytosine / Q000031:analogs & derivatives / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000139:chemically induced* / Q000276:immunology; D007968:Leukoencephalopathy, Progressive Multifocal / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D015767:Mefloquine / Q000627:therapeutic use; D008803:Mianserin / Q000031:analogs & derivatives / Q000627:therapeutic use; D000078785:Mirtazapine; D063065:Organophosphonates / Q000627:therapeutic use; D016713:Ritanserin / Q000627:therapeutic use; D012702:Serotonin Antagonists / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D000998:Antiviral Agents; D063065:Organophosphonates; D012702:Serotonin Antagonists; D003561:Cytarabine; D016713:Ritanserin; D008803:Mianserin; D003596:Cytosine; D000078785:Mirtazapine; D000077404:Cidofovir; D015767:Mefloquine