PMID- 37899047
OWN - NLM
STAT- MEDLINE
DCOM- 20231110
LR  - 20231113
IS  - 1678-4227 (Electronic)
IS  - 0004-282X (Print)
IS  - 0004-282X (Linking)
VI  - 81
IP  - 10
DP  - 2023 Oct
TI  - Acquired immunodeficiency syndrome-related progressive multifocal 
      leukoencephalopathy-immune reconstitution inflammatory syndrome: prevalence, main 
      characteristics, and outcomes in a Brazilian center.
PG  - 883-890
LID - 10.1055/s-0043-1772831 [doi]
AB  - BACKGROUND: Progressive multifocal leukoencephalopathy (PML) - immune 
      reconstitution inflammatory syndrome (IRIS) in people living with HIV/AIDS 
      (PLWHA) has been rarely described in low- and middle-income countries. OBJECTIVE: 
      To describe the prevalence of PML-IRIS among PLWHA with PML and its main features 
      in a tertiary hospital in Brazil. METHODS: We performed a retrospective cohort 
      study. We included PLWHA with PML-IRIS patients admitted at Instituto de 
      Infectologia Emilio Ribas, Sao Paulo, Brazil, between 2011 and 2021. We retrieved 
      information on neurological manifestations, neuroimaging findings, treatments, 
      and outcomes. RESULTS: We identified 11 (11.8%) PML-IRIS cases among 93 patients 
      with definite PML. Eight (73%) cases were men and had a median (IQR) age of 41 
      (27-50) years. Seven (63.6%) patients developed unmasking PML-IRIS and 4 (36.4%) 
      had paradoxical PML-IRIS. The median (IQR) time from initiation of combined 
      antiretroviral therapy (cART) to IRIS diagnosis was 49 (30-70) days. Ten (90.9%) 
      patients received corticosteroids. There were 4 (36%) in-hospital deaths and 3 
      were associated with hospital-acquired pneumonia. Among the 7 (64%) patients who 
      survived, 5 (71.5%) had sequelae at discharge. One year after the PML-IRIS 
      diagnosis, 6 (54.5%) patients were alive. CONCLUSION: The prevalence of PML-IRIS 
      was 11.8%. Most patients had unmasking PML-IRIS. In-hospital mortality and 
      morbidity were high. One-year survival was similar to that described in some 
      high-income countries.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution 4.0 International License, permitting copying 
      and reproduction so long as the original work is given appropriate credit 
      (https://creativecommons.org/licenses/by/4.0/).
FAU - Santana, Monize Nascimento
AU  - Santana MN
AUID- ORCID: 0009-0005-7035-583X
AD  - Instituto de Infectologia Emilio Ribas, Departamento de Infectologia, Sao Paulo 
      SP, Brazil.
FAU - Ferrari, Raphaela
AU  - Ferrari R
AUID- ORCID: 0009-0000-3888-9288
AD  - Instituto de Infectologia Emilio Ribas, Departamento de Infectologia, Sao Paulo 
      SP, Brazil.
FAU - Macedo, Arthur Cassa
AU  - Macedo AC
AUID- ORCID: 0000-0002-3957-0284
AD  - McGill University, Department of Neurology and Neurosurgery, Montreal QC, Canada.
FAU - Marcusso, Rosa Maria Nascimento
AU  - Marcusso RMN
AUID- ORCID: 0000-0002-8396-0263
AD  - Instituto de Infectologia Emilio Ribas, Departamento de Neurologia, Sao Paulo SP, 
      Brazil.
FAU - Fernandes, Ruan de Andrade
AU  - Fernandes RA
AUID- ORCID: 0000-0001-5451-9578
AD  - Instituto de Infectologia Emilio Ribas, Departamento de Infectologia, Sao Paulo 
      SP, Brazil.
FAU - Vidal, Jose Ernesto
AU  - Vidal JE
AUID- ORCID: 0000-0001-7830-8716
AD  - Instituto de Infectologia Emilio Ribas, Departamento de Neurologia, Sao Paulo SP, 
      Brazil.
AD  - Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas, 
      Departamento de Molestias Infecciosas e Parasitarias, Sao Paulo SP, Brazil.
AD  - Universidade de Sao Paulo, Faculdade de Medicina, Laboratorio de Investigacao 
      Medica (LIM 49), Sao Paulo SP, Brazil.
LA  - eng
PT  - Journal Article
TT  - Sindrome inflamatoria de reconstituicao imune da leucoencefalopatia multifocal 
      progressiva associada a sindrome da imunodeficiencia adquirida: prevalencia, 
      principais caracteristicas e desfecho em um hospital brasileiro.
DEP - 20231029
PL  - Germany
TA  - Arq Neuropsiquiatr
JT  - Arquivos de neuro-psiquiatria
JID - 0125444
SB  - IM
MH  - Male
MH  - Humans
MH  - Adult
MH  - Middle Aged
MH  - Female
MH  - *Leukoencephalopathy, Progressive Multifocal/epidemiology
MH  - *Acquired Immunodeficiency Syndrome/complications/drug therapy
MH  - Brazil/epidemiology
MH  - *Immune Reconstitution Inflammatory Syndrome/epidemiology/diagnosis
MH  - Retrospective Studies
MH  - Prevalence
PMC - PMC10631851
COIS- The authors have no conflict of interest to declare.
EDAT- 2023/10/30 00:41
MHDA- 2023/11/10 06:45
PMCR- 2023/10/01
CRDT- 2023/10/29 19:43
PHST- 2023/11/10 06:45 [medline]
PHST- 2023/10/30 00:41 [pubmed]
PHST- 2023/10/29 19:43 [entrez]
PHST- 2023/10/01 00:00 [pmc-release]
AID - ANP-23-0051 [pii]
AID - 10.1055/s-0043-1772831 [doi]
PST - ppublish
SO  - Arq Neuropsiquiatr. 2023 Oct;81(10):883-890. doi: 10.1055/s-0043-1772831. Epub 
      2023 Oct 29.