AIDS-related progressive multifocal leukoencephalopathy

Abrão, Carolina de Oliveira; Silva, Lissa Rodrigues Machado da; Souza, Luiz Carlos Silva; Bisso, Nathalia de Mello; Turchi, Marília Dalva; Guilarde, Adriana Oliveira

doi:10.1590/0037-8682-0252-2020

Cited by 5 publications

(2 citation statements)

References 9 publications

(14 reference statements)

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“…4,5 However, the disease still carries a poor prognosis, with rapid progression and death usually occurring within 6 months. 6 Patients with HIV-associated PML are often left with neurological symptoms, even if they have received HAART. PML also has diverse clinical manifestations depending on the localization of the brain lesions.…”

Section: Introductionmentioning

confidence: 99%

“…With the widespread implementation of highly active antiretroviral therapy (HAART), studies have shown that the incidence rates of PML have considerably declined 4,5 . However, the disease still carries a poor prognosis, with rapid progression and death usually occurring within 6 months 6 . Patients with HIV‐associated PML are often left with neurological symptoms, even if they have received HAART.…”

Section: Introductionmentioning

confidence: 99%

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Progressive multifocal leukoencephalopathy in an HIV patient: A case report and literature review

Lei,

Deng,

et al. 2023

Clinical Case Reports

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Key Clinical MessageProgressive multifocal leukoencephalopathy (PML) is a rare opportunistic infection of the brain caused by reactivation of the JC virus, which can lead to a lytic infection of oligodendrocytes. We report a patient with HIV who developed PML.AbstractProgressive multifocal leukoencephalopathy (PML) is a rare opportunistic infection of the brain caused by reactivation of the John Cunningham virus (JCV), which can lead to a lytic infection of oligodendrocytes. Herein, we report the case of a patient with HIV who developed PML that presented as a progressive disturbance of consciousness and movement. The patient's clinical symptoms progressively deteriorated, and positive JC viral DNA in his cerebrospinal fluid (CSF) helped us diagnose him with PML. Magnetic resonance imaging (MRI) showed multiple asymmetric subcortical and deep white‐matter lesions. Although we administered immunoreconstructive therapy, the patient's condition gradually worsened. Therefore, we suggest that PML should be considered if such lesions are found in MRIs of HIV patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Progressive multifocal leukoencephalopathy in an HIV patient: A case report and literature review

Lei,

Deng,

et al. 2023

Clinical Case Reports

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Molecular diagnosis of opportunistic infections in the central nervous system of HIV-infected adults in Manaus, Amazonas

de Melo,

Pinto,

Ferreira

et al. 2024

Front. Med.

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BackgroundOpportunistic infections in the central nervous system (CNS) of people with HIV/AIDS (PLWHA) remain significant contributors to morbidity and mortality, especially in resource-limited scenarios. Diagnosing these infections can be challenging, as brain imaging is non-specific and expensive. Therefore, molecular analysis of cerebrospinal fluid (CSF) may offer a more accurate and affordable method for diagnosing pathogens.MethodsWe conducted extensive real-time PCR testing (qPCR) on CSF to evaluate etiological agents in PLWHA with neurological manifestations. Primers targeting DNA from specific pathogens, including cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein–Barr virus (EBV), John Cunningham virus (JCV), Toxoplasma gondii, and human T-lymphotropic virus types 1 and 2 (HTLV-1 and HTLV-2), were used.ResultsCerebrospinal fluid samples revealed 90 pathogens (36.7%). Toxoplasma gondii was the most frequently detected pathogen, found in 22 samples (30.5%). Other pathogens included Cryptococcus sp. (7.7%), EBV (5.3%), CMV, VZV, and JCV (4.0% each).ConclusionDespite antiretroviral therapy and medical follow-up, opportunistic central nervous system infections remain frequent in PLWHA. Herpesviruses are commonly detected, but T. gondii is the most prevalent opportunistic pathogen in our study population. Therefore, molecular diagnosis is a crucial tool for identifying opportunistic infections, even in patients undergoing treatment.

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Analysis of John Cunningham Virus DNA in Immunosuppressed Patients

KIRCA,

DİNÇ

2023

Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi

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Progresif multifokal lökoensefalopati (PML), John Cunningham Virüsünün (JCV) etken olduğu merkezi sinir sisteminin demiyelinizan bir hastalığıdır. İmmünkompetan bireylerde JCV nadiren patojeniktir, ancak immünsuprese hastalarda reaktive olarak PML’ye neden olabilir. Bu çalışmanın amacı, JCV enfeksiyonu için risk grubunda olan immünsuprese hastalarda JCV DNA’sının kantitatif gerçek zamanlı polimeraz zincir reksiyonu (RT-PCR) ile analizi ve PML hastalığında viral yük ve örnek tiplerinin tanı koymadaki performansının değerlendirilmesidir Mart 2019-Mayıs 2023 tarihleri arasında Ankara Bilkent Şehir Hastanesi Moleküler Mikrobiyoloji Laboratuvarına JCV tanısı için gönderilen, 115 hastaya ait toplam 142 örneğin JCV RT-PCR sonuçları retrospektif olarak değerlendirilmiştir. Klinik örneklerde nükleik asit izolasyonundan sonra amplifikasyon, RealStar® JCV PCR Kit 1.0 kullanılarak Rotor-Gene Q cihazında kantitatif olarak RT- PCR yöntemi ile çalışılmıştır. İncelenen hastaların %11’inde JCV DNA pozitif bulunmuş ve bunlardan 4 hasta klinik ve radyolojik bulguların desteklediği PML tanısı almıştır. PML tanısı almış 3 hastanın viral yük düzeyleri BOS’ta 104, 104 ve102 kopya/ml, diğer hastanın viral yük düzeyi plazmada önce 101 kopya/ml bulunmuş, ancak ardışık incelemede 102 kopya/ml’ye artış gösterdiği tespit edilmiştir. PML tanısı almayan hastaların plazmalarında viral yük ise 101 kopya/ml bulunmuştur. PML’nin erken tanısı, tedavinin planlanması açısından önem taşımaktadır. BOS örneğinde JCV DNA tespiti tanı için oldukça hassas ve spesifik olarak kabul edilmektedir. Bu çalışmada, BOS’un alınamadığı durumlarda ardışık çalışılan plazma örneklerinde virüs yükünde artış bulunmasının tanıda değerli olabileceği sonucuna varılmıştır.

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AIDS-related progressive multifocal leukoencephalopathy

Cited by 5 publications

References 9 publications

Progressive multifocal leukoencephalopathy in an HIV patient: A case report and literature review

Progressive multifocal leukoencephalopathy in an HIV patient: A case report and literature review

Molecular diagnosis of opportunistic infections in the central nervous system of HIV-infected adults in Manaus, Amazonas

Analysis of John Cunningham Virus DNA in Immunosuppressed Patients

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