Remission of progressive multifocal leukoencephalopathy following highly active antiretroviral therapy in a patient with HIV infection

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease resulting from lytic infection of oligodendrocytes by the papovavirus JC ( JCV). PML has also been recognized as an AIDS-defining-illness. The inciden ce of MML has increased since 1987 and it occurs in up to 4% of patients wi th AIDS. To date, there is no treatment available for PML and it usually re sults in death within 3-6 months of diagnosis. However, there are some repo rts of remission of PML after antiretroviral therapy. We report a 12-year-o ld child with hemophilia B and developing AIDS with the onset of PML. With highly active antiretroviral therapy, PML subsided with an increase of CD4 count from 10 to 30/mu l in spite of about 1.0 x 10(4) human immunodeficien cy virus (HIV)-1-RNA copies. He has survived more than 1 year without speci fic therapy against JCV. Highly active antiretroviral therapy appears to ha ve improved his prognosis in HIV-associated PML. (C) 1999 Elsevier Science B.V. All rights reserved.