title: Recurrence of progressive multifocal leukoencephalopathy despite immune recovery in two HIV seropositive individuals.
abstract: We present two cases of recurrent progressive multifocal leukoencephalopathy (PML) in patients with long standing virally suppressed human immunodeficiency virus (HIV) and normal CD4+ T cell count who were taking stable regimens of highly active antiretroviral therapy (HAART). This has significant implications for other patients with a past history of PML, not just those with HIV but also those on medications such as natalizumab or fumarates.
authors.affiliation: Department of Neurology, St Vincent's Hospital, Level 4 Xavier Building, Sydney, 2010, Australia. kate.crossley@health.nsw.gov.au.
authors.forename: Kate M
authors.identifier: 0000-0003-0553-1903
authors.initials: KM
authors.lastname: Crossley
authors.affiliation: Division of Neuro Immunology, Center for Virology and Vaccine Research, Beth Deaconess Medical Center, Boston, USA.
authors.forename: Shruti
authors.initials: S
authors.lastname: Agnihotri
authors.affiliation: Department of Radiology, St Vincent's Hospital, Sydney, Australia.
authors.forename: Joga
authors.initials: J
authors.lastname: Chaganti
authors.affiliation: Department of Neuropathology, St Vincent's Hospital, Sydney, Australia.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Rodriguez
authors.affiliation: Department of Molecular Medicine, St Vincent's Hospital, Sydney, Australia.
authors.forename: Leon Patrick
authors.initials: LP
authors.lastname: McNally
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston, USA.
authors.forename: Nagagopal
authors.initials: N
authors.lastname: Venna
authors.affiliation: Department of Infectious Diseases, Massachusetts General Hospital, Boston, USA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Turbett
authors.affiliation: Department of Neurosurgery, St Vincent's Hospital, Sydney, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Gutman
authors.affiliation: Department of Anatomical Pathology, St Vincent's Hospital, Sydney, Australia.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Morey
authors.affiliation: Division of Neuro Immunology, Center for Virology and Vaccine Research, Beth Deaconess Medical Center, Boston, USA.
authors.forename: Igor J
authors.initials: IJ
authors.lastname: Koralnik
authors.affiliation: Department of Neurology, St Vincent's Hospital, Sydney Australia, also Peter Duncan Neurosciences Unit Neurosciences Program, St Vincent's Centre for Applied Medical Research, Sydney, Australia.|Department of Infectious Diseases and Immunology, St Vincent's Hospital, Sydney Australia, also Peter Duncan Neurosciences Unit Neurosciences Program, St Vincent's Centre for Applied Medical Research, Sydney, Australia.
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Brew
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000821:virology; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000276:immunology / Q000472:pathogenicity; D006801:Humans; D007577:JC Virus / Q000276:immunology / Q000472:pathogenicity; D007968:Leukoencephalopathy, Progressive Multifocal / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D000069442:Natalizumab / Q000627:therapeutic use*; D012008:Recurrence
chemical_list: D019380:Anti-HIV Agents; D000069442:Natalizumab
keywords: Neuroimmunology; Neurovirology; Progressive multifocal leukoencephalopathy