The Effect of Potent Antiretroviral Therapy and JC Virus Load in Cerebrospinal Fluid on Clinical Outcome of Patients with AIDS-Associated Progressive Multifocal Leukoencephalopathy [DeLuca A, et al. JID 2000;182:1077]: This is a multicenter study from Italy concerning 57 consecutive patients with HIV infection and PML. With HAART, 26% showed neurologic improvement, 57% had undetectable JCV DNA levels in the CSF, and 46% survived over one year. The authors conclude that HAART is associated with clinical improvement of PML and control of JCV replication.
Comment: The results of HAART on PML have been variable, including a negative report by these same authors [AIDS 1998;12:1937]. They now claim that this was simply the initial experience with 10 subjects who were included in the current report, but the subsequent experience has been quite different. Nevertheless, the follow-up period was relatively brief, and the number of patients who responded was modest. The authors also point out that they have experienced nine patients who had PML develop after initiating HAART. posted 10/19/2000