Cidofovir treatment of progressive multifocal leukoencephalopathy in a patient receiving highly active antiretroviral therapy

R. R. Razonable, Allen J. Aksamit, Alan J. Wright, John W. Wilson

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Progressive multifocal leukoencephalopathy (PML), a frequently fatal demyelinating disease caused by JC virus, occurs as an opportunistic infection in patients with acquired immunodeficiency syndrome. Curative therapy has been elusive, but recent reports suggest its improvement after institution of highly active antiretroviral therapy (HAART). We describe a case of PML that developed 6 months after the patient, a 55-year-old man, began to receive HAART. The PML progressed despite good virologic and immunologic response to HAART. Substantial symptomatic and radiographic improvement occurred after the addition of cidofovir to the treatment regimen. We reviewed the scientific literature on this rare occurrence of PML after institution of HAART and describe the patient characteristics, potential pathogenesis, and therapeutic options, including the successful use of cidofovir as an adjunctive agent.

Original languageEnglish (US)
Article number62509
Pages (from-to)1171-1175
Number of pages5
JournalMayo Clinic proceedings
Volume76
Issue number11
DOIs
StatePublished - Nov 2001

Keywords

  • AIDS = acquired immunodeficiency syndrome
  • CSF = cerebrospinal fluid
  • HAART = highly active antiretroviral therapy
  • HIV = human immunodeficiency virus
  • JCV = JC virus
  • MRI = magnetic resonance imaging
  • PCR = polymerase chain reaction
  • PI = protease inhibitor
  • PML = progressive multifocal leukoencephalopathy

ASJC Scopus subject areas

  • General Medicine

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