Journal Article

Clinical Course and Prognostic Factors of Progressive Multifocal Leukoencephalopathy in Patients Treated with Highly Active Antiretroviral Therapy

Juan Berenguer, Pilar Miralles, Julio Arrizabalaga, Esteban Ribera, Fernando Dronda, Josu Baraia-Etxaburu, Pere Domingo, Manuel Márquez, Francisco J. Rodriguez-Arrondo, Fernando Laguna, Rafael Rubio, José Lacruz Rodrigo, J. Mallolas and Verónica de Miguel

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 36, issue 8, pages 1047-1052
Published in print April 2003 | ISSN: 1058-4838
Published online April 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/374048
Clinical Course and Prognostic Factors of Progressive Multifocal Leukoencephalopathy in Patients Treated with Highly Active Antiretroviral Therapy

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We analyzed survival rates, neurologic function, and prognostic factors for 118 consecutive patients with acquired immunodeficiency syndrome-associated progressive multifocal leukoencephalopathy (PML) treated with highly active antiretroviral therapy (HAART) in 11 hospitals throughout Spain. Seventy-five patients (63.6%) remained alive for a median of 114 weeks (2.2 years) after diagnosis of PML. Neurologic function of the survivors was categorized as cure or improvement in 33, stabilization or worsening in 40, and unknown in 2. The baseline CD4+cell count was the only variable found with prognostic significance. The odds ratio of death was 2.71 (95% confidence interval, 1.19–6.15) for patients with CD4+cell counts of <100 cells/μL, compared with patients who had CD4+cell counts of ⩾100 cells/μL. One-third of patients with PML died despite receipt of HAART; neurologic function improved in approximately one-half of the survivors. A CD4+cell count of <100 cells/μL was associated with higher mortality.

Journal Article.  3537 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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