一名HIV感染患者在接受高效抗逆转录病毒治疗后，进行性多灶性白质脑病缓解。

Remission of progressive multifocal leukoencephalopathy following highly active antiretroviral therapy in a patient with HIV infection.

作者信息

Inui K, Miyagawa H, Sashihara J, Miyoshi H, Tanaka-Taya K, Nishigaki T, Teraoka S, Mano T, Ono J, Okada S

机构信息

Department of Pediatrics, Faculty of Medicine, Osaka University, Suita, Japan.

出版信息

Brain Dev. 1999 Sep;21(6):416-9. doi: 10.1016/s0387-7604(99)00038-8.

DOI:10.1016/s0387-7604(99)00038-8

PMID:10487477

Abstract

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease resulting from lytic infection of oligodendrocytes by the papovavirus JC (JCV). PML has also been recognized as an AIDS-defining illness. The incidence of PML has increased since 1987 and it occurs in up to 4% of patients with AIDS. To date, there is no treatment available for PML and it usually results in death within 3-6 months of diagnosis. However, there are some reports of remission of PML after antiretroviral therapy. We report a 12-year-old child with hemophilia B and developing AIDS with the onset of PML. With highly active antiretroviral therapy, PML subsided with an increase of CD4 count from 10 to 300/microl in spite of about 1.0 X 10(4) human immunodeficiency virus (HIV)-1-RNA copies. He has survived more than 1 year without specific therapy against JCV. Highly active antiretroviral therapy appears to have improved his prognosis in HIV-associated PML.

摘要

进行性多灶性白质脑病（PML）是一种脱髓鞘疾病，由乳头多瘤空泡病毒JC（JCV）对少突胶质细胞的溶解性感染引起。PML也被认为是一种艾滋病界定疾病。自1987年以来，PML的发病率有所上升，在高达4%的艾滋病患者中发生。迄今为止，尚无针对PML的治疗方法，通常在诊断后3至6个月内导致死亡。然而，有一些关于抗逆转录病毒治疗后PML缓解的报道。我们报告一名患有乙型血友病并发展为艾滋病且伴有PML发作的12岁儿童。尽管有大约1.0×10⁴人类免疫缺陷病毒（HIV）-1-RNA拷贝，但通过高效抗逆转录病毒治疗，PML消退，同时CD4计数从10升至300/微升。他在未接受针对JCV的特异性治疗的情况下存活了超过1年。高效抗逆转录病毒治疗似乎改善了他在HIV相关PML中的预后。