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Maraviroc Failed to Control Progressive Multifocal Leukoencephalopathy-Associated IRIS in a Patient with Advanced HIV

Mónica Rodríguez1, Fernando Antonio Silva-Sánchez1, César Luna-Rivero2

  • 1Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Calzada de Tlalpan 4502, Colonia Sección XVI, 14080 México, DF, Mexico.

Case Reports in Medicine
|January 15, 2015
PubMed

Insights

Maraviroc showed limited efficacy for progressive multifocal leukoencephalopathy-associated immune reconstitution inflammatory syndrome (PML-associated IRIS) in an advanced HIV patient. Further research is needed to determine its therapeutic role in PML-associated IRIS.

Area of Science:

  • Neuroimmunology
  • Infectious Diseases
  • HIV Medicine

Background:

  • Progressive multifocal leukoencephalopathy-associated immune reconstitution inflammatory syndrome (PML-associated IRIS) lacks effective treatments.
  • Maraviroc has been considered a potential therapeutic option for PML-associated IRIS.

Purpose of the Study:

  • To report a case of PML-associated IRIS in an advanced HIV patient treated with maraviroc.
  • To evaluate the efficacy of maraviroc in managing PML-associated IRIS.

Main Methods:

  • Case report of an advanced HIV patient.
  • Treatment with maraviroc in addition to suppressive antiretroviral therapy (ART).
  • Clinical and neurological outcome assessment.

Main Results:

  • The patient developed PML-associated IRIS and had a fatal outcome.
  • Despite the addition of maraviroc to ART, neurological deterioration occurred.

Conclusions:

  • Maraviroc may not be effective in all cases of PML-associated IRIS.
  • Further studies are required to define the role of maraviroc in PML-associated IRIS.
  • Identifying patient subgroups who may benefit from maraviroc is crucial.

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