Human immunodeficiency virus (HIV)-associated progressive multifocal leukoencephalopathy (PML) remains a relevant clinical problem even in the era of highly active antiretroviral therapy (HAART). Aims of the study were to analyze clinical and treatment-related features and the survival probability of PML patients observed within the Italian Registry Investigative Neuro AIDS (IRINA) during a 29-month period of HAART. Intravenous drug use, the presence of focal signs, and the involvement of white matter at neuroradiology increased the risk of having PML. A reduced probability of PML was observed when meningeal signs were reported. Patients starting HAART at PML diagnosis and previously naive for antiretrovirals showed significantly higher 1-year probability of survival (.58), compared to those continuing HAART (.24), or never receiving HAART (.00). Higher CD4 cell count were associated with a higher survival probability (.45). At multivariate analysis, a younger age, higher CD4, starting HAART at PML diagnosis, the absence of previous acquired immunodeficiency syndrome (AIDS)-defining events, and the absence of a severe neurologic impairment were all associated with a reduced hazard of death. The use of cidofovir showed a trend towards a reduced risk of death.

Clinical epidemiology and survival of progressive multifocal leukoencephalopathy in the era of highly active antiretroviral therapy: Data from the Italian Registry Investigative Neuro AIDS (IRINA) / A., Antinori; A., Cingolani; P., Lorenzini; M. L., Giancola; I., Uccella; S., Bossolasco; S., Grisetti; F., Moretti; B., Vigo; M., Bongiovanni; B., Del Grosso; M. I., Arcidiacono; G. C., Fibbia; M., Mena; M. G., Finazzi; Guaraldi, Giovanni; A., Ammassari; A., D'Arminio Monforte; P., Cinque; A., De Luca. - In: JOURNAL OF NEUROVIROLOGY. - ISSN 1355-0284. - STAMPA. - 9 Suppl 1(2003), pp. 47-53.

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