Kuls-Oszmaniec Aleksandra, Nagańska Anna, Kowalski Jacek, Cholewińska Grażyna, Leńska-Mieciek Marta, Fiszer Urszula
Department of Neurology and Epileptology, Prof. Orlowski's Hospital, Centre of Postgraduate Medical Education, Warsaw, Poland.
Regional Hospital for Infectious Diseases in Warsaw, Poland.
Postep Psychiatr Neurol. 2025 Sep;34(3):207-215. doi: 10.5114/ppn.2025.153597. Epub 2025 Aug 26.
Progressive multifocal leukoencephalopathy (PML) is a lethal demyelinating disease of the central nervous system caused by John Cunningham virus (JCV). PML develops due to the reactivation of latent JCV infection in individuals with cellular immunodeficiency. Since the beginning of acquired immunodeficiency syndrome (AIDS) epidemic, human immunodeficiency virus (HIV) infection has remained a leading cause of PML with the condition recognized as an AIDS-defining illness. The clinical manifestations of PML may vary depending on the underlying condition. In AIDS-associated PML, the symptoms include motor weakness, speech or language disturbances, cognitive and behavioral changes and gait abnormalities and incoordination.
We present the case of a male patient who developed PML as the first clinical manifestation of a newly diagnosed HIV infection.
The introduction of antiretroviral therapy has led to a significant decrease in the morbidity and mortality due to the opportunistic infections in HIV-positive patients. However, the improvement is least pronounced in case of PML.
进行性多灶性白质脑病（PML）是一种由约翰·坎宁安病毒（JCV）引起的致命性中枢神经系统脱髓鞘疾病。PML是由于细胞免疫缺陷个体中潜伏的JCV感染重新激活而发生的。自获得性免疫缺陷综合征（AIDS）流行开始以来，人类免疫缺陷病毒（HIV）感染一直是PML的主要病因，该病被视为一种艾滋病定义疾病。PML的临床表现可能因潜在疾病而异。在与艾滋病相关的PML中，症状包括运动无力、言语或语言障碍、认知和行为改变以及步态异常和共济失调。
我们报告一例男性患者，其PML是新诊断的HIV感染的首发临床表现。
抗逆转录病毒疗法的引入已使HIV阳性患者因机会性感染导致的发病率和死亡率显著降低。然而，在PML病例中，改善最不明显。
