HIV treatment & PML

Michael Carter for Aidsmap (April 30, 2009)

HIV treatment lowers incidence of PML and improves survival if it develops

The incidence of progressive multifocal leukoencephalopathy (PML) in people with HIV declined significantly after the introduction of effective antiretroviral therapy, Swiss investigators report in the May 15^th edition of Clinical Infectious Diseases. The researchers also found that HIV treatment led to a significant improvement in the duration of survival for patients diagnosed with this condition.

PML is a disease of the central nervous system caused by JC virus. It is very rare, but is often fatal in patients with impaired immunity, including individuals with HIV.

Studies conducted before effective combination antiretroviral therapy became available in the late 1990s reported a prevalence of PML amongst people with HIV of between 0.3 and 0.8%. Less than one tenth of patients survived more than one year.

There are, however, limited data about the incidence of PML and its mortality in the era since effective HIV treatment became available. Investigators from the Swiss HIV Cohort Study therefore undertook research to address these issues.

They conclude, “the results of this study, covering 20 years…demonstrate that the introduction of combination antiretroviral therapy has led to a decrease in the incidence of PML amongst HIV-infected patients and has reduced PML-attributable 1-year mortality, regardless of baseline CD4 T cell count.”

Reference

Incidence and outcome of progressive multifocal leukoencephalopathy over 20 years of the Swiss HIV Cohort Study.
Nina Khanna et al
Clinical Infectious Diseases 48: 1459-66, 2009.
Link to CID abstract

Link to Aidsmap article