Rodríguez Mónica, Silva-Sánchez Fernando Antonio, Luna-Rivero César, Vega-Barrientos Ricardo, Alvarado-de la Barrera Claudia, Reyes-Terán Gustavo
Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Calzada de Tlalpan 4502, Colonia Sección XVI, 14080 México, DF, Mexico.
Servicio de Patología, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, 14080 México, DF, Mexico.
Case Rep Med. 2014;2014:381480. doi: 10.1155/2014/381480. Epub 2014 Dec 23.
Due to the lack of therapeutic options for patients with progressive multifocal leukoencephalopathy-associated immune reconstitution inflammatory syndrome (PML-associated IRIS), maraviroc has generated expectations among the medical community. However, we report a patient with advanced HIV infection, who developed PML-associated IRIS and had a fatal outcome despite the addition of maraviroc to suppressive ART. Future studies are required to define the therapeutic role of maraviroc in PML-associated IRIS and differentiate individuals who may benefit from maraviroc from those who may develop neurological deterioration.
由于进行性多灶性白质脑病相关免疫重建炎症综合征(PML相关IRIS)患者缺乏治疗选择,马拉维若在医学界引起了期待。然而,我们报告了一名晚期HIV感染患者,该患者发生了PML相关IRIS,尽管在抑制性抗逆转录病毒治疗(ART)中加用了马拉维若,但仍出现致命结局。需要开展进一步研究来明确马拉维若在PML相关IRIS中的治疗作用,并区分可能从马拉维若中获益的个体与可能发生神经功能恶化的个体。