Clinical epidemiology and survival of progressive multifocal leukoencephalopathy in the era of highly active antiretroviral therapy: Data from the Italian Registry Investigative Neuro AIDS (IRINA)

Andrea Antinori, Antonella Cingolani, Patrizia Lorenzini, Maria Letizia Giancola, ILaria Uccella, Simona Bossolasco, Susanna Grisetti, Francesca Moretti, Beniamino Vigo, Marco Bongiovanni, Bruno Del Grosso, Maria Irene Arcidiacono, Giovanni Carlo Fibbia, Maurizio Mena, Maria Grazia Finazzi, Giovanni Guaraldi, Adriana Ammassari, Antonella d'Arminio Monforte, Paola Cinque, Andrea De LucaF. Burzacchini, L. Mecocci, P. Giorni, L. Monno, G. Fasulo, O. Moling, S. Brighi, L. Sighinolfi, P. Corsi, M. T. Di Toro, A. Mastroianni, M. De Simone, G. Mazzarello, T. Carli, S. Artioli, A. Vetica, P. Congedo, P. Zannoni, S. Foresti, M. Figoni, E. R. Dallenogare, G. Rotondo, A. Agostinone, A. Mariano, A. Donisi, A. Vivarelli, L. Loiacono, B. Gigli, D. Larussa, M. Ciardi, F. Viviani, M. Palumbo, L. Cristiano, F. Speranza

Research output: Contribution to journalArticle

Abstract

Human immunodeficiency virus (HIV)-associated progressive multifocal leukoencephalopathy (PML) remains a relevant clinical problem even in the era of highly active antiretroviral therapy (HAART). Aims of the study were to analyze clinical and treatment-related features and the survival probability of PML patients observed within the Italian Registry Investigative Neuro AIDS (IRINA) during a 29-month period of HAART. Intravenous drug use, the presence of focal signs, and the involvement of white matter at neuroradiology increased the risk of having PML. A reduced probability of PML was observed when meningeal signs were reported. Patients starting HAART at PML diagnosis and previously naïve for antiretrovirals showed significantly higher 1-year probability of survival (.58), compared to those continuing HAART (.24), or never receiving HAART (.00). Higher CD4 cell count were associated with a higher survival probability (.45). At multivariate analysis, a younger age, higher CD4, starting HAART at PML diagnosis, the absence of previous acquired immunodeficiency syndrome (AIDS)-defining events, and the absence of a severe neurologic impairment were all associated with a reduced hazard of death. The use of cidofovir showed a trend towards a reduced risk of death.

Original languageEnglish
Pages (from-to)47-53
Number of pages7
JournalJournal of NeuroVirology
Volume9
Issue numberSUPPL. 1
Publication statusPublished - 2003

Keywords

  • AIDS
  • Antiretroviral therapy
  • Central nervous system
  • HIV
  • JCV
  • PML
  • Prevalence

ASJC Scopus subject areas

  • Virology
  • Clinical Neurology

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    Antinori, A., Cingolani, A., Lorenzini, P., Giancola, M. L., Uccella, IL., Bossolasco, S., Grisetti, S., Moretti, F., Vigo, B., Bongiovanni, M., Del Grosso, B., Arcidiacono, M. I., Fibbia, G. C., Mena, M., Finazzi, M. G., Guaraldi, G., Ammassari, A., d'Arminio Monforte, A., Cinque, P., ... Speranza, F. (2003). Clinical epidemiology and survival of progressive multifocal leukoencephalopathy in the era of highly active antiretroviral therapy: Data from the Italian Registry Investigative Neuro AIDS (IRINA). Journal of NeuroVirology, 9(SUPPL. 1), 47-53.