Progressive multifocal leukoencephalopathy in 17 AIDS patients

We describe retrospectively the course of 17 AIDS patients with progressive multifocal leukoencephalopathy (PML) and give a review of their clinical s ymptoms and survival times. The relative frequency of PML in our cohort of AIDS patients was 2.6%. The mean of CD4-positive cells was 80.5+/-82.5/mu l . CD4-positive cells were >200/mu l only in one patient and increased signi ficantly under a combination of three antiretroviral drugs whereas, with th e other patients, CD4-positive cells did not increase with a maximum of two antiretroviral drugs. The mean survival time was 6.6 (1.5-20) months and c orrelated positively with the number of CD4-positive cells. The diagnosis o f PML can be regarded as confirmed when JC-virus DNA is detectable in cereb rospinal fluid, typical changes can be seen in MRI and typical clinical sym ptoms occur. No effective therapy is known to date. Single case reports on therapy with cidofovir, as in one of the cases described here, showed positive results.