Hryzhak Ihor, Pryshlyak Olexandra, Gryb Victoria, Prokopovich Marianna, Prokofiev Mykola, Matviiuk Olga, Diomina Nataliya, Hryzhak Lilia
Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine.
Communal non-commercial enterprise "Center of Infection Diseases of Ivano-Frankivsk Regional Council", Ivano-Frankivsk, Ukraine.
Prague Med Rep. 2025;126(2):86-91. doi: 10.14712/23362936.2025.14.
Subacute sclerosing panencephalitis (SSPE) is the result of a chronic infection of the central nervous system caused by a mutated measles virus. We present a case of SSPE in a 19-year-old female with congenital HIV-infection. The patient has been using antiretroviral therapy regularly since she was 4 years old. At the age of 15, she contracted measles of moderate severity. At the age 17, she had the HIV viral load < 20 copies/ml and the CD4 count 420 cells/μl. Three years after measles, bilateral necrotizing retinitis developed, and five months later, myoclonic seizures of the left limbs. Symptoms progressed gradually, with fever, generalised seizures, and lost consciousness. She was hospitalized in department for treatment patient with HIV-infection. Magnetic resonance imaging of the brain revealed massive areas of the altered signal without clear contours in both hemispheres of the brain, which captured the white and grey matter of the fronto-parietal, temporal-occipital lobes. The electroencephalography showed the flashes of slow-wave paroxysmal activity of the brain in the delta range, mainly in the fronto-parietal area. In the cerebral spinal fluid, anti-measles IgG was detected at a titre of 3738,408 U/ml, and in the blood - 9.4 U/ml. A diagnosis of SSPE was established. Supportive, corticosteroids and anticonvulsant treatment were ineffective. Patient died 10 months after the onset of the disease. Therefore, measles at any age in a person with congenital HIV-infection poses a risk of developing SSPE.
亚急性硬化性全脑炎（SSPE）是由变异麻疹病毒引起的中枢神经系统慢性感染的结果。我们报告一例19岁先天性HIV感染女性的SSPE病例。该患者自4岁起就定期接受抗逆转录病毒治疗。15岁时，她感染了中度严重的麻疹。17岁时，她的HIV病毒载量<20拷贝/ml，CD4细胞计数为420个/μl。麻疹发作三年后，出现双侧坏死性视网膜炎，五个月后，左侧肢体出现肌阵挛性癫痫发作。症状逐渐进展，伴有发热、全身性癫痫发作和意识丧失。她因HIV感染患者在该科室住院治疗。脑部磁共振成像显示双侧大脑半球有大片信号改变区域，边界不清，累及额顶叶、颞枕叶的白质和灰质。脑电图显示大脑在δ波范围内有慢波阵发性活动，主要在额顶叶区域。脑脊液中检测到抗麻疹IgG，滴度为3738408 U/ml，血液中为9.4 U/ml。确诊为SSPE。支持性治疗、使用皮质类固醇和抗惊厥药物治疗均无效。患者在疾病发作10个月后死亡。因此，先天性HIV感染患者在任何年龄感染麻疹都有发生SSPE的风险。
