Naslov
A review of HIV positive patients with progressive multifocal leukoencephalopathy treated at University hospital for Infectious Diseases "Dr. Fran Mihaljević" in Zagreb from 2011 to 2019

Autori
Atelj, Anita ; Romih Pintar, Vanja ; Lukas, Davorka ; Zekan, Šime ; Begovac, Josip

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
2nd South-East European Conference on Travel, Tropical, Migration Medicine and HIV and the 3rd Croatian Conference on Travel, Tropical, Migration Medicine and HIV

Mjesto i datum
Dubrovnik, Hrvatska, 04.04.2019. - 07.04.2019

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
HIV ; Progresive multifocal leucoencephalopathy ; PML ; Croatia

Sažetak
OBJECTIVES: Progressive multifocal leukoencephalopathy (PML) caused by the reactivation of JC virus is a progressive demyelinating central nervous system disease occurring in immunocompromised patients, such as patients with HIV infection with CD4+ T lymphocyte count bellow 200/mm3. Our goal was to give an overview of HIV patients with PML treated at our clinic in the period from 2011 to 2019. METHODS:The database of the Croatian HIV cohort was examined and all patients with positive JC virus from cerebrospinal fluid from January 2011 to March 2019 were extracted. We present their laboratory, epidemiological and clinical data. RESULTS: In the examined period a total of 6 patients with HIV infection were diagnosed with PML by detection of JCV DNA in cerebrospinal fluid. All treated patients were males aged between 28 and 49 belonging to MSM (men who have sex with men) risk group. All patients had CD4+ lymphocyte count bellow 100/mm3 at the time of presentation and in all PML was the first AIDS indicator disease. One patient developed PML due to discontinuation of antiretroviral therapy (ART) several years after the diagnosis and another had PML-IRIS after the introduction of ART. Three of six patients died with a median survival rate of 175 days (range 24-256 days), and all three surviving patients had neurologic sequele. CONCLUSION: Although relatively rare, PML must be considered in immunocompromised patients with neurological deficits. Since we had a small number of patients, no statistically significant conclusions could be made. However, it is clear that PML remains a debilitating and deadly disease for many patients with HIV despite antiretroviral therapy. Our data corresponds with the data from the literature stating one-year survival rate of 50% or more in patients on ART and 55 to 80% chance of severe neurologic sequelae in survivors.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA