Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
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Original Article

Volume 3, Number 1, February 2011, pages 17-22

From Clinical Presentation to the Outcome: the Natural History of PML in a Portuguese Population of HIV Infected Patients


Table 1. Clinical and Biological Features and Outcome of 25 AIDS-Associated PML Patients
PatientsSexRoute of transmissionYear of PML diagnosisAge at PML diagnosisTime between HIV and PML diagnosis (months)CD4 count at onset of PML (cells/μl)HIV viral loadMain clinical symptomsAntiretroviral therapy before PMLTreatment started after PMLClinical evolutionTime of follow up (months)Main event/Outcome
M - Male, F - Female, Unk - Unknown, AZT - Zidovudine, 3TC - Lamivudine, NVP - Nevirapine, RTV - Ritonavir, FPV - Fosamprenavir, IDV - Indinavir, NFV - Nelfinavir, LPV - Lopinavir, EFV - Efavirenz
1MDrug abuse200932312213000Convulsions, gait ataxia, unilateral paresisNoneAZT/3TC/NVPWorse/progression4Dead (bacterial pneumonia)
2MDrug abuse20074596767517ConvulsionsNoneAZT/3TC/RTV/FPVPartial recovery31Dead (pneumonia H1N1)
3MDrug abuse199735018313580Sensitivity disturbance, unilateral paresisNoneAZT/3TC/IDVTotal recovery139Dead (car accident with polytrauma)
4MSexual199743073UnkCognitive/behavioral disturbance, speech disorder, unilateral paresisNoneAZT/3TC/IDVSame state11Lost
5MBM transplant1995189494UnkUnilateral paresisAZTAZTWorse/progression5Dead (PML progression)
6MSexual199949014> 500000Speech disorder, unilateral paresisNoneAZT/3TC/NFVSame state0.75Lost
7MSexual19923438UnkHeadache, sensitivity disturbance, unilateral paresisNoneNoneWorse/progression1Dead (PML progression)
8MDrug abuse199531730UnkSensitivity disturbance, unilateral paresisAZTAZTSame state2Dead (bacterial pneumonia)
9MSexual199232603UnkSensitivity disturbance, unilateral paresisAZTAZTWorse/progression1Dead (bacterial pneumonia)
10FSexual1993294724UnkSpeech disorder, unilateral paresisNoneAZTPartial recovery1Lost
11MDrug abuse199943012757533Visual and speech disorder, unilateral paresisNoneAZT/3TC/IDVTotal recovery131Alive
12MDrug abuse199739113UnkCognitive/behavioral and visual disturbance, unilateral paresisAZT/3TC/IDVAZT/3TC/IDVSame state0.75Dead (bacterial pneumonia)
13MSexual199858063UnkSpeech disorder, unilateral paresisNoneAZT/3TC/IDVWorse/progression1Lost
14MSexual20082305576621ConvulsionsNoneAZT/3TC/NVPPartial recovery28Alive
15MSexual2004271.534UnkVisual disorder, gait ataxia, bilateral paresisAZT/3TC/IDV/LPV/RTVAZT/3TC/IDV/LPV/RTVWorse/progression1Lost
16MDrug abuse2001350132UnkConvulsionsNoneAZT/3TC/NFVSame state20Lost
17MDrug abuse200336425UnkCognitive/behavioral disturbanceNoneAZT/3TC/NFV/NVPWorse/progression0.6Dead (bacterial pneumonia)
18MSexual20014801473024Cognitive/behavioral disturbanceNoneAZT/3TC/NVP/NFVWorse/progression8Dead (systemic cryptococcosis)
19FSexual200253Unk580UnkCognitive/behavioral disturbance, unilateral paresisUnknownContinuation of the same therapyWorse/progression0Dead (PML progression)
20MSexual2006410184406979Speech disorder, unilateral paresisNoneAZT/3TC/EFVWorse/progression4Dead (PML progression)
21MSexual2001575173UnkSpeech disorder, convulsions, unilateral paresisNoneAZT/3TC/IDVPartial recovery84Dead (bacterial pneumonia)
22MDrug abuse2001300.542UnkBilateral paresisNoneAZT/3TC/IDVPartial recovery105Alive
23MSexual200744011131239Cognitive and speech disturbanceNoneAZT/3TC/FPV/RTVSame state1Lost
24FDrug abuse1995400175UnkHeadache, unilateral paresisNoneAZTWorse/progression60Lost
25FSexual200947129717< 20Speech disorder, gait ataxiaAZT/3TC/EFVABA/3TC/EFVWorse/progression11Dead (PML progression)


Table 2. Differences Between Pre-HAART and Post-HAART Era Concerning CD4 T Cell Count, Age of Diagnosis (PML and HIV) and Death Causes
CharacteristicAll (n = 25)PML diagnosis
Before 1997 (n = 6)1997 - 2009 (n = 19)
Gender4 female, 21 male2 female, 4 male2 female, 17 male
CD4+ cell count at diagnosis, median (IQR), cell/μl73 (19 - 152.5)27 (6.75 - 114.25)76 (34 - 173)
Age at HIV diagnosis, median (IQR), years35.5 (30.25 - 43.0)29 (20.75 - 34.75)37.5 (32.75 - 45)
Age at PML diagnosis, median (IQR), years39.0 (31.5 - 46.0)31.5 (26.25 - 31.5)43.0 (35.0 - 48.0)
Time between HIV and PML diagnosis, median (IQR), months0.75 (0.0 - 33.25)27.0 (2.25 - 68.5)0.0 (0 - 3.5)
Death (all causes)14410
Death (attributed to PML progression)52 (50%)3 (30%)