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Cureus 2021 Oct 5;13(10):e18494. Epub 2021 Oct 5.

Internal Medicine, Mount Sinai Hospital, Chicago, USA.

Human immunodeficiency virus (HIV) encephalopathy lies in the severe spectrum of HIV-associated neurological disorder (HAND) and ranges from asymptomatic condition to minor neurological features to severe dementia. Cerebrospinal fluid (CSF) analysis helps to rule out the presence of other opportunistic infections. Neuroimaging helps establish the diagnosis. Read More

Braz J Infect Dis 2016 Jul-Aug;20(4):360-4. Epub 2016 Jun 5.

Universidade Federal do Pará (UFPA), Instituto de Ciências Biológicas, Laboratório de Vírus, Belem, Para, Brazil.

JC virus (JCV) is a member of the Polyomaviridae family and is associated to a severe disease known as progressive multifocal leukoencephalopathy, PML, which is gradually increasing in incidence as an opportunistic infection among AIDS patients. The present study aimed to investigate the occurrence of JCV among HIV-1 carriers including their types and molecular subtypes and the possible association with disease. Urine samples from 66 HIV-1 infected subjects were investigated for the presence of the virus by amplifying VP1 (215bp) and IG (610bp) regions using the polymerase chain reaction. Read More

HIV Med 2013 May 6;14(5):321-5. Epub 2012 Dec 6.

Department of Infectious Diseases, Hospital Universitario Son Espases, Carretera de Valldemosa SN, Palma de Mallorca, Illes Balears, Spain.

Objectives: The aim of the study was to investigate whether survival after progressive multifocal leukoencephalopathy (PML) diagnosis in HIV-1-infected patients was associated with central nervous system penetration-effectiveness (CPE) score and the presence or absence of protease inhibitors in the treatment regimen.

Methods: In the absence of treatments demonstrated to be effective for PML in HIV-1-infected patients and in the light of the controversy surrounding the use of CPE scores to make decisions on treatment after diagnosis, we determined whether there were differences in survival at 1 year depending on the type and characteristics of treatment. A multicentre retrospective observational study including three Spanish hospitals was carried out for the period from 1 January 1994 to 31 December 2009. Read More

Clin Neurol Neurosurg 2013 Jul 12;115(7):995-1002. Epub 2012 Nov 12.

Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.

Background: Focal brain lesions (FBL) in HIV/AIDS frequently pose a diagnostic dilemma as the etiology varies from infective (tuberculoma, toxoplasmosis and tuberculous abscesses) to neoplastic lesions like lymphoma. For determining etiology, advanced neuroimaging techniques, serological and molecular biological tests have been evolved with varying sensitivities/specificities. Stereotactic biopsy (STB) of the lesions is reserved for lesions unresponsive to appropriate therapy. Read More

Infez Med 2009 Mar;17(1):35-7

Unit of Infectious Diseases, University of Verona, Ospedale Policlinico,Verona, Italy.

We describe the clinical course of an HIV-infected patient with progressive multifocal leukoencephalopathy who took mirtazapine for his depression. After six months of therapy the clinical symptoms had not worsened and the neuroradiological image of the brain was unchanged. Further studies are necessary to determine the effect of serotonin receptor antagonist in treating PML associated to HIV. Read More

J Acquir Immune Defic Syndr 2008 Sep;49(1):26-31

Infectious Disease Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain.

Background: The aim of this study was to analyze the incidence of new cases, survival of HIV-1-infected patients with progressive multifocal leukoencephalopathy (PML), and the characteristics of PML-associated immune reconstitution inflammatory syndrome (IRIS).

Methods: Multicenter observational cohort study of all HIV-1-infected patients newly diagnosed of PML in 7 hospitals in Barcelona (Spain) from 2002 to 2006. The annual incidence of PML was calculated. Read More

Front Biosci 2006 Jan 1;11:718-32. Epub 2006 Jan 1.

Center for Neurovirology and Cancer Biology, Laboratory of Neuropathology and Molecular Pathology, Temple University, Philadelphia, Pennsylvania 19122, USA.

Infection with HIV-1 has spread exponentially in recent years to reach alarming proportions. It is estimated than more than 33 million adults and 1.3 million children are infected worldwide. Read More

Clin Infect Dis 2000 Jan;30(1):95-9

Division of Infectious Diseases, San Raffaele Hospital, 20127 Milano, Italy.

Cerebrospinal fluid (CSF) samples were examined from 7 patients infected with human immunodeficiency virus type 1 (HIV-1) who had progressive multifocal leukoencephalopathy (PML). Samples were obtained both before and after 35-365 days of highly active antiretroviral therapy (HAART). By polymerase chain reaction, JC virus (JCV) DNA was found in 6 of 7 patients at baseline but in only 1 patient after HAART. Read More

Med Clin (Barc) 1999 Sep;113(6):210-4

Unidad de Enfermedades Infecciosas, Hospital Central de Asturias, Universidad de Oviedo.

Background: The clinical, neuroimaging, virologic and evolutive characteristics of progressive multifocal leukoencephalopathy (PML) in 35 AIDS patients are studied.

Patients And Methods: PML was diagnosed by clinical and neuroimaging criteria in 32 patients and by autopsy in other three. The detection of JC virus (JCV) was done by PCR and further hybridization of the amplified DNA in peripheral blood lymphocytes, urine and CSF. Read More

Clin Infect Dis 1999 May;28(5):1152-4

Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63108, USA.

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. Read More

J Infect Dis 1998 Dec;178(6):1816-20

Department of Microbiology, Paul Brousse Hosptial, Cedex, France.

JC virus (JCV) load was determined by using quantitative polymerase chain reaction in cerebrospinal fluid (CSF) of 12 patients with AIDS-associated progressive multifocal leukoencephalopathy (PML) and compared with clinical outcome. JCV loads varied widely (3-7 log10 JCV equivalents/mL of CSF) and were apparently not related to absolute CD4 cell counts or CSF and plasma human immunodeficiency virus type 1 loads. A significant correlation was observed between JCV load and survival time (Spearman's rank correlation, -0. Read More

J Neurol Sci 1997 Mar;147(1):63-72

Department of Neurology, Heinrich-Heine-Universität, Federal Republic of Germany.

The diagnosis of definite progressive multifocal leukoencephalopathy (PML) has been a neuropathological domain. We reviewed all Human Immunodeficiency Virus Type 1 (HIV-1) seropositive patients in our institution between 01.01. Read More

Ophthalmology 1996 Jun;103(6):899-906

Kresge Eye Institute, Wayne State University School of Medicine, Detroit, MI, USA.

Purpose: Progressive multifocal leukoencephalopathy (PML) is increasingly described as a late complication of the acquired immune deficiency syndrome (AIDS). The purpose of this study is to evaluate retrospectively the ophthalmologic, clinical, and investigational aspects of AIDS-associated PML.

Methods: The authors evaluated ten patients in whom ophthalmologic manifestations developed in the course of AIDS-associated PML. Read More

Bildgebung 1995 Dec;62(4):310-9

Neurologische Klinik, Universität Düsseldorf, Germany.

Since 1983, central nervous system (CNS) involvement in acquired immune deficiency syndrome (AIDS) is well recognized. Imaging methods are important in diagnosing AIDS-related primary and secondary CNS processes as HIV-1-associated encephalopathy, cerebral toxoplasmosis, primary CNS lymphoma, cytomegalovirus (CMV) encephalitis, progressive multifocal leukoencephalopathy (PML), and infectious spinal cord granulomas. This paper presents a review of typical AIDS-related CNS findings as seen in morphological radiologic techniques, i. Read More

Q J Nucl Med 1995 Sep;39(3):243-9

University College London Medical School, Middlesex Hospital, UK.

Infection with the human immunodeficiency virus-type 1 (HIV-1) may produce a variety of central nervous system (CNS) symptoms and signs. CNS involvement in patients with the acquired immunodeficiency syndrome (AIDS) includes AIDS dementia complex or HIV-1 associated cognitive/motor complex (widely known as HIV encephalopathy), progressive multifocal leucoencephalopathy (PML), opportunistic infections such as Toxoplasma gondii, TB, Cryptococcus and infiltration by non-Hodgkin's B cell lymphoma. High resolution structural imaging investigations, either X-ray Computed Tomography (CT scan) or Magnetic Resonance Imaging (MRI) have contributed to the understanding and definition of cerebral damage caused by HIV encephalopathy. Read More