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J Acquir Immune Defic Syndr ; 49(1): 26-31, 2008 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-18667930

RESUMO

BACKGROUND: The aim of this study was to analyze the incidence of new cases, survival of HIV-1-infected patients with progressive multifocal leukoencephalopathy (PML), and the characteristics of PML-associated immune reconstitution inflammatory syndrome (IRIS). METHODS: Multicenter observational cohort study of all HIV-1-infected patients newly diagnosed of PML in 7 hospitals in Barcelona (Spain) from 2002 to 2006. The annual incidence of PML was calculated. Survival was estimated using the Kaplan-Meier method. IRIS was defined as new onset or rapid worsening of PML shortly after initiation of highly active antiretroviral therapy together with a decline in HIV-1 viral load and rising of CD4 lymphocytes. RESULTS: Sixty-one new cases of PML were diagnosed. The mean survival time was 15 months [95% confidence interval (CI), 11 to 19]. The Kaplan-Meier estimates of the probability of survival were 47.7% (95% CI, 35 to 59) at 6 months, 38.6% (95% CI, 25 to 51) at 12 months, 35.1% (95% CI, 22 to 48) at 24 months, and 25.1% (95% CI, 10 to 40) at 36 months. IRIS was diagnosed in 14 (23%) cases. Mortality was similar in patients with and without IRIS. CONCLUSIONS: PML continues to be one of the deadliest opportunistic infections in acquired immunodeficiency syndrome patients. The development of PML-associated IRIS has no influence on prognosis.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/complicações , Terapia Antirretroviral de Alta Atividade , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , HIV-1 , Leucoencefalopatia Multifocal Progressiva/complicações , Adulto , Estudos de Coortes , Feminino , Infecções por HIV/mortalidade , Humanos , Doenças do Sistema Imunitário/complicações , Doenças do Sistema Imunitário/mortalidade , Leucoencefalopatia Multifocal Progressiva/mortalidade , Masculino , Pessoa de Meia-Idade , Análise de Sobrevida
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