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AIDS-related progressive multifocal leukoencephalopathy
Carolina de Oliveira Abrão1, Lissa Rodrigues Machado da Silva1, Luiz Carlos Silva Souza1,2
1Secretaria de Estado da Saúde de Goiás, Hospital de Doenças Tropicais Dr. Anuar Auad, Goiânia, GO, Brasil.
Introduction:
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by reactivation of JC virus (JCV).
Methods:
We described the profile of laboratory-confirmed PML cases among AIDS patients.
Results:
A total of 43 HIV patients with clinical conditions compatible with PML were obtained; 5 cases were confirmed by JCV testing. The main clinical finding was mental confusion. Median CD4 count was 54 cells/mm³.
Conclusions:
Three of the five confirmed PML cases died; the time between diagnosis and death was 2, 5, and 6 months. It is important to consider JCV infection as a differential diagnosis.
Insights
Progressive multifocal leukoencephalopathy (PML) is a serious brain condition caused by JC virus (JCV) reactivation. In AIDS patients, PML presents with confusion and a low CD4 count, often leading to fatal outcomes.
Area of Science:
- Neuroscience
- Infectious Diseases
- Immunology
Background:
- Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system.
- PML is caused by the reactivation of the John Cunningham virus (JCV).
Purpose of the Study:
- To describe the clinical profile of laboratory-confirmed PML cases in patients with Acquired Immunodeficiency Syndrome (AIDS).
Main Methods:
- Retrospective analysis of 43 HIV-positive patients with suspected PML.
- Confirmation of PML through JCV testing.
Main Results:
- Five cases of PML were confirmed among 43 patients.
- The primary clinical manifestation was mental confusion.
- The median CD4+ T-cell count was 54 cells/mm³.
Conclusions:
- PML is a significant concern in HIV/AIDS patients, often presenting with neurological deficits.
- Three of the five confirmed PML cases resulted in death within 2-6 months of diagnosis.
- JCV infection should be considered in the differential diagnosis of neurological conditions in immunocompromised individuals.
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