Abstract |
Progressive multifocal leukoencephalopathy (PML) is a rare, opportunistic infection of the CNS by the ubiquitous JC virus (JCV). PML is only seen in the context of severe and prolonged immunosuppression, a phenomenon now frequently encountered since the AIDS pandemic. PML is characterised by progressive lysis of oligodendrocytes with demyelination. A rapid clinical course ensues with focal neurological deficits and a median time to death of 3.5 months without treatment. Prior to highly active antiretroviral therapy ( HAART), there was no effective therapy. Since the advent of HAART, the prognosis for PML has much improved; however, a significant number of patients appear unresponsive to antiretrovirals and some worsen because of the development of immune reconstitution disease. A better understanding of the biology of JCV and its interactions with host cells is leading to new anti-JCV-specific agents that await evaluation in randomised, controlled trials. Improved diagnostic tools and the possibility of immunotherapy and gene therapy are further advancing the field.
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Authors | Mark T M Roberts |
Journal | CNS drugs
(CNS Drugs)
Vol. 19
Issue 8
Pg. 671-82
( 2005)
ISSN: 1172-7047 [Print] New Zealand |
PMID | 16097849
(Publication Type: Journal Article, Review)
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Chemical References |
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Topics |
- Acquired Immunodeficiency Syndrome
(complications, drug therapy, epidemiology)
- Anti-HIV Agents
(therapeutic use)
- Humans
- Immunotherapy
- JC Virus
- Leukoencephalopathy, Progressive Multifocal
(epidemiology, etiology)
- Polyomavirus Infections
(complications, drug therapy)
- Treatment Outcome
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