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Progressive multifocal leukoencephalopathy in persons infected with human immunodeficiency virus, san francisco, 1981–1989
Author(s) -
Gillespie Sheila M.,
Chang Yuan,
Lemp George,
Arthur Ray,
Buchbinder Susan,
Steimle Anthony,
Baumgartner James,
Rando Thomas,
Neal Denesse,
Rutherford George,
Schonberger Lawrence,
Janssen Robert
Publication year - 1991
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410300413
Subject(s) - progressive multifocal leukoencephalopathy , jc virus , medicine , leukoencephalopathy , antibody , human immunodeficiency virus (hiv) , viral disease , virus , slow virus , disease , virology , opportunistic infection , immunopathology , immunology , pediatrics
Progressive multifocal leukoencephalopathy (PML), a rare neurological disease, has been sporadically reported in persons infected with human immunodeficiency virus (HIV), the causative agent of acquired immune deficiency syndrome (AIDS). From January 1981 through February 1989, in San Francisco, we identified 94 HIV‐infected persons with PML, of whom 48 (51%) were pathologically confirmed (as required for AIDS case reporting). These 48 patients were significantly older when diagnosed with AIDS (20% older than 50 years) than patients with AIDS without PML. The remaining 46 (49%) patients, diagnosed clinically and by neuroimaging, did not differ significantly from definitive patients in demographic or survival characteristics after PML diagnosis. We detected antibodies to JC virus, the causative agent of PML, in 9 of 14 (64%) AIDS‐related patients with PML, and in 9 of 14 (64%) matched control subjects, suggesting that determination of JC virus antibody status before AIDS diagnosis does not reliably indicate which patients will contract PML. Our study shows that the proportion of patients with AIDS who contracted PML remained stable between 1981 and 1988, but increased in the first 2 months of 1989. Our findings further indicate that PML in HIV‐infected patients may be underestimated by as much as 50%.