PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATH Y IN THE ACQUIRED-IMMUNODEFICIENCY-SYNDROME

Progressive multifocal leukoencephalopathy (PML) is a rare opportunist ic infection in HIV-infected persons. We present the characteristics o f seven cases of PML, which represent 3.1% of our patients with AIDS. In six cases, was the <<marker>> disease for AIDS. The most common cli nical manifestation was a slowly evolving focal neurological syndrome (average time of pre-hospitalization symptoms was 64 days). The number of T4 lymphocytes at the moment of diagnosis varied between 14 and 12 1 cel/mm3 (median: 51). Computerized tomography (CT) and craneal nucle ar magnetic resonance (NMR) showed images of single (4 cases) or multi ple white substance involvement without contrast uptake or mass-effect . The definitive diagnosis was made by cerebral biopsy. Four died with in 20 to 90 days of diagnosis. Three of the five who received antiretr ovirals survived with apparent stabilization of the process at 2, 13, and 23 months of diagnosis. PML can be an initial diagnostic disease f or AIDS. Its symptoms and the CT/NMR should arouse suspicion. However, given that clinicoradiological data are often insufficient, it is adv isable to conduct cerebral biopsies. Antiretovirals may have a favorab le effect on diseases course.