PMID- 28991708
OWN - NLM
STAT- MEDLINE
DCOM- 20180611
LR  - 20180611
IS  - 1878-5883 (Electronic)
IS  - 0022-510X (Linking)
VI  - 381
DP  - 2017 Oct 15
TI  - Post-cART progressive multifocal leukoencephalopathy era in a Brazilian center.
PG  - 321-324
LID - S0022-510X(17)33768-1 [pii]
LID - 10.1016/j.jns.2017.09.002 [doi]
AB  - Progressive multifocal leukoencephalopathy (PML) is lytic infection of 
      oligodendrocytes caused by JC virus (JCV). While PML incidence in developing 
      countries has decreased after the introduction of combination antiretroviral 
      therapy (cART), data in developing countries is scarce and limited to few 
      cohorts. We described the epidemiological and clinical profile of a group of 
      Brazilian HIV infected patients with PML in the cART era. A total of 27 patients 
      were included in the study. The median age at PML onset was 42years (range: 
      27-67years) and 18 (66.7%) were men. The median CD4+ T cell count at the time of 
      diagnosis was 67cells/mm(3) and the median HIV viral load was 27,000copies/ml. 
      Motor deficits were the most common early manifestations (44%). Seizures occurred 
      in 37% of the patients and 9 (33.3%) had PML associated with immune 
      reconstitution inflammatory syndrome (IRIS). Mortality was 33% and lower age at 
      PML onset was associated with survival (p: 0.013). Our results are in accordance 
      with previous published series of PML cases. Factors such as genetic background, 
      regional JCV subtype differences, death from other diseases and underdiagnosis 
      may explain the low prevalence of reported PML cases in developing countries.
CI  - Copyright (c) 2017 Elsevier B.V. All rights reserved.
FAU - Lima, Marco A
AU  - Lima MA
AD  - Laboratory for Clinical Research in Neuroinfection, National Institute of 
      Infectious Diseases Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil; Neurology 
      Service, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic 
      address: marco.lima@ini.fiocruz.br.
FAU - Silva, Marcus Tulius T
AU  - Silva MTT
AD  - Laboratory of Viral Pathogenesis, National Institute of Infectious Diseases 
      Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
FAU - Afonso, Livia A
AU  - Afonso LA
AD  - Neurology Service, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
FAU - Vaz, Beatriz J P
AU  - Vaz BJP
AD  - Laboratory of Viral Pathogenesis, National Institute of Infectious Diseases 
      Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
LA  - eng
PT  - Journal Article
DEP - 20170904
PL  - Netherlands
TA  - J Neurol Sci
JT  - Journal of the neurological sciences
JID - 0375403
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-HIV Agents/*therapeutic use
MH  - Brazil
MH  - Female
MH  - HIV Infections/complications/*drug therapy/*epidemiology/physiopathology
MH  - Humans
MH  - Leukoencephalopathy, Progressive 
      Multifocal/*complications/*epidemiology/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Antiretroviral therapy
OT  - HIV
OT  - Highly active
OT  - Leukoencephalopathy
OT  - Progressive multifocal
EDAT- 2017/10/11 06:00
MHDA- 2018/06/12 06:00
CRDT- 2017/10/10 06:00
PHST- 2016/11/20 00:00 [received]
PHST- 2017/08/03 00:00 [revised]
PHST- 2017/09/01 00:00 [accepted]
PHST- 2017/10/10 06:00 [entrez]
PHST- 2017/10/11 06:00 [pubmed]
PHST- 2018/06/12 06:00 [medline]
AID - S0022-510X(17)33768-1 [pii]
AID - 10.1016/j.jns.2017.09.002 [doi]
PST - ppublish
SO  - J Neurol Sci. 2017 Oct 15;381:321-324. doi: 10.1016/j.jns.2017.09.002. Epub 2017 
      Sep 4.