a Department of Microbiology, Immunology and Infectious Diseases , University of Montreal, Succursale Centre Ville , Montreal , Quebec , Canada.
b Département de microbiologie et maladies infectieuses , Hôtel-Dieu Hospital du Centre Hospitalier de l'Université de Montréal (CHUM) , Montreal , Quebec , Canada.
Expert Rev Anti Infect Ther. 2016;14(2):177-91. doi: 10.1586/14787210.2016.1132162. Epub 2016 Jan 4.
Progressive multifocal encephalopathy (PML) caused by JC virus was frequently encountered in AIDS patients before combination antiretroviral therapy (cART). Incidence decreased and the outcome improved with cART. The immune reconstitution with cART is beneficial for HIV-infected patients and is an effective treatment for PML. However, when it is excessive an inflammatory response immune syndrome might occur with deterioration of PML. So far, no specific therapy has proven efficacious in small clinical trials in spite of some optimistic case reports. Combination of drugs targeted at different stages of JC virus life cycle seems to have a better effect. Passive and active immune therapies, immune competence "boosters" appear promising. New future approaches such as gene editing are not far away.
进行性多灶性脑白质病（PML）由 JC 病毒引起，在联合抗逆转录病毒治疗（cART）之前，常发生于艾滋病患者中。随着 cART 的应用，其发病率降低，预后改善。cART 诱导的免疫重建有利于 HIV 感染者，是 PML 的有效治疗方法。然而，当免疫重建过度时，可能会发生炎症反应免疫综合征，导致 PML 恶化。到目前为止，尽管有一些乐观的病例报告，但小规模临床试验均未证实有特效疗法。针对 JC 病毒生命周期不同阶段的药物联合似乎效果更好。被动和主动免疫治疗、免疫能力“增强剂”似乎很有前途。新的未来方法，如基因编辑，也已在研究中。
