Date Published:
2007
Publication Type:
Journal Article
Authors:
Secondary:
Annals of Neurology
Volume:
62
Pagination:
34-9
URL:
https://pubmed.ncbi.nlm.nih.gov/
Keywords:
Adult;Aged;Antiretroviral Therapy;Biopsy;Brain;CD4 Lymphocyte Count;Chi-Square Distribution;Citation;External;Female;Highly Active;HIV;HIV Infections;Humans;Leukoencephalopathy;Magnetic Resonance Imaging;Male;Middl;Progressive Multifocal
Abstract:
<p>OBJECTIVE: Inflammatory progressive multifocal leukoencephalopathy (iPML) with enhancing magnetic resonance imaging (MRI) lesions and leukocyte infiltration occurs in human immunodeficiency virus (HIV)-infected individuals after highly active antiretroviral therapy (HAART) treatment. MRI diagnostic criteria for PML suggest that iPML does not occur in HIV-negative individuals. METHODS: We studied pathologically proved PML (12 by biopsy, 9 with MRI, 32 at autopsy). RESULTS: HIV-negative (2/5) and -positive (2/4) PML patients had enhancing MRI lesions, correlated with CD3(+) lymphocyte infiltration. Inflammatory infiltrates occurred in the majority of HIV-negative (7/8) and HIV-positive/HAART (17/20) cases (p > 0.2), but in only 2 of 16 HIV-positive/non-HAART cases (p < 0.001). INTERPRETATION: iPML showed radiographic and pathological similarity in HIV-positive/HAART and HIV-negative patients. HIV-negative iPML necessitates further consideration of MRI criteria for PML.</p>