Subacute sclerosing panencephalitis in a child with human immunodeficiency virus (HIV) infection on antiretroviral therapy

Muthusamy, Karthik; Yoganathan, Sangeetha; Thomas, Maya; Alexander, Mathew; Verghese, Valsan Philip

doi:10.4103/0972-2327.144299

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…HIV impacts the immune system that can eventually affect the course of SSPE. Anti‐retroviral therapy induced changes in the immunological status has also been postulated to be a cause for its fulminant course 14‐16 …”

Section: Introductionmentioning

confidence: 99%

“…Anti-retroviral therapy induced changes in the immunological status has also been postulated to be a cause for its fulminant course. [14][15][16] Variations in interferon and cytokine responses, as well as cellmediated immunity, might attribute to the cause of the disease; in addition, data is sparse on the virus's genetic variations and the contribution of stage of the disease or the patient's genetic background. As a result, drawing conclusions is challenging.…”

Section: Introductionmentioning

confidence: 99%

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Immune‐dysregulation in subacute sclerosing panencephalitis: An exploratory case–control study

Vijayvarman

Malhotra

Rizvi

et al. 2023

Journal of Medical Virology

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Subacute sclerosing panencephalitis (SSPE) is a chronic progressive neurological condition caused by a defective measles virus. It is postulated that immune‐dysregulation might result in persistent infection (immune evasion) as well as initiation of autoimmune phenomenon (via natural killer cells) leading to panencephalitis. The primary objective of this case‐control study was to analyse the pattern of immune dysregulation in cases with SSPE. The secondary objective was to assess the correlation between the measured immunological variables and disability/death at 6 months. This was an exploratory case–control study conducted at a tertiary‐care referral‐facility from January 2020 to September 2021. Thirty consecutive patients fulfilling the Dyken's criteria for SSPE and 30 age‐and‐sex‐matched healthy controls were enrolled. Immunological profile constituted by lymphocyte subset analysis, immunoglobulin levels and complement levels were done in all cases and controls. Cases were staged as per Jabbour's system; disability was assessed using the modified Rankin Scale (mRS). Patients with SSPE had a mean age of 14.76 years (±6.9 years). There were 25 males and 5 females; 6.7% cases belonged to Jabbour's first stage, 40% to second stage and 53.3% to third stage. At least 1/4th had evidence of measles vaccination. Levels of absolute lymphocyte count, B‐cells, T cells, helper T‐cells, and cytotoxic T‐cells were significantly higher in cases. IgG, IgM, and IgE levels were significantly higher while IgD levels were significantly lower in cases. At baseline, 13.3% of cases had a mRS score of 0–2 and 86.7% had a score of 3–6; at 6 months 10% had a mRS score 0–2 (favorable outcome) while 90% had a mRS score 3–6 (poor outcome). Higher IgE levels were found to correlate significantly with favorable outcome. Immune‐dysregulation may play a significant role in shaping one's response to measles infection as well as in determining vaccine‐efficacy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Immune‐dysregulation in subacute sclerosing panencephalitis: An exploratory case–control study

Vijayvarman

Malhotra

Rizvi

et al. 2023

Journal of Medical Virology

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“…Slow progression can be expected in children on HAART. SSPE is a slow viral disease caused by altered measles virus with a progressive course [ 5 ]. There are not a great number of reports of SSPE in HIV-infected children in describing its progression.…”

Section: Introductionmentioning

confidence: 99%

Subacute Sclerosing Panencephalitis in a Child Suffering from Human Immunodeficiency Virus on “Highly Active Antiretroviral Therapy” – Can This be Another Instance of Immune Reconstitution Inflammatory Syndrome?

Gupta

Kushwaha

Manzoor

et al. 2017

Cureus

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We report a 12-year-old boy with human immunodeficiency virus (HIV) who presented with rapidly progressive difficulty in ambulation. The symptoms started to worsen when he was put on antiretroviral therapy (ART). Our findings show that the dynamics of HIV-related immune suppression and highly active antiretroviral therapy (HAART) have an impact on the clinical course of Subacute sclerosing panencephalitis (SSPE). Slow progression is expected in children on HAART but in our case, we observe a complex interaction of the virus with the immune system and modification of disease course of SSPE with ART. The child we discuss in this case report developed rapidly progressive SSPE on HAART regime; so the possibility of SSPE to be labeled as immune reconstitution inflammatory syndrome (IRIS) should be considered.

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Clinical features, pathogenesis, pathology, neuroimaging, clinical course and outcome of measles inclusion-body encephalitis: a systematic review of published case reports and case series

Garg,

Suresh,

Suvirya

et al. 2024

Neurol Sci

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Subacute sclerosing panencephalitis in a child with human immunodeficiency virus (HIV) infection on antiretroviral therapy

Cited by 5 publications

References 15 publications

Immune‐dysregulation in subacute sclerosing panencephalitis: An exploratory case–control study

Immune‐dysregulation in subacute sclerosing panencephalitis: An exploratory case–control study

Subacute Sclerosing Panencephalitis in a Child Suffering from Human Immunodeficiency Virus on “Highly Active Antiretroviral Therapy” – Can This be Another Instance of Immune Reconstitution Inflammatory Syndrome?

Clinical features, pathogenesis, pathology, neuroimaging, clinical course and outcome of measles inclusion-body encephalitis: a systematic review of published case reports and case series

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