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Detectable cerebrospinal fluid JCV DNA in late-presenting HIV-positive patients: beyond progressive multifocal leukoencephalopathy?

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Abstract

In the absence of effective prophylaxis and treatment, therapeutic options in HIV-positive patients with progressive multifocal leukoencephalopathy (PML) are limited to antiretroviral therapy: nevertheless, outcome is poor. We conducted a retrospective study (2009–2015) describing the outcome of 25 HIV-positive patients with detectable cerebrospinal fluid JC virus DNA: 14 had a probable PML while the others had evidence of other inflammatory central nervous system (CNS) affecting disorders. In the former group, 6-month mortality was 45.5% vs 21.4 in the latter one: survival was higher than previously described but no predictor of poor outcome was identified. Two patients treated with 5HT2-inhibitors survived. The contributing role of JCV replication in other CNS-affecting disorders needs to be assessed as well as the benefits of 5HT2-inhibitors in HIV-positive patients with proven PML.

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Authors and Affiliations

  1. Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Amedeo di Savoia Hospital, C.so Svizzera 164, 10149, Turin, Italy

    S. Mornese Pinna, E. Scarvaglieri, S. Audagnotto, F. Lipani, S. Bonora, G. Di Perri & A Calcagno

  2. Laboratory of Microbiology and Molecular Biology, Ospedale Amedeo di Savoia, ASL TO2, Turin, Italy

    M. G. Milia & V. Ghisetti

  3. Unit of Neurology, Ospedale Maria Vittoria, ASL TO2, Turin, Italy

    D. Imperiale

  4. Unit of Radiology, Ospedale San Giovanni Bosco, ASL TO2, Turin, Italy

    A. Prochet

Authors
  1. S. Mornese Pinna
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  2. E. Scarvaglieri
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  3. M. G. Milia
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  4. D. Imperiale
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  5. V. Ghisetti
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  6. S. Audagnotto
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  7. A. Prochet
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  8. F. Lipani
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  9. S. Bonora
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  10. G. Di Perri
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  11. A Calcagno
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Corresponding author

Correspondence to S. Mornese Pinna.

Ethics declarations

The study was approved by the local ethics committee and patients signed a written informed consent.

Conflict of interest

GDP and SB have received honoraria from Abbvie, BMS, Gilead, Janssen-Cilag, MSD, Viiv. For the remaining authors, none were declared. AC has received honoraria from Abbvie, BMS, Gilead, Janssen-Cilag, MSD, Viiv and he is currently receiving research grants from BMS, Gilead, and Viiv.

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Mornese Pinna, S., Scarvaglieri, E., Milia, M.G. et al. Detectable cerebrospinal fluid JCV DNA in late-presenting HIV-positive patients: beyond progressive multifocal leukoencephalopathy?. J. Neurovirol. 23, 763–767 (2017). https://doi.org/10.1007/s13365-017-0549-5

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  • DOI: https://doi.org/10.1007/s13365-017-0549-5

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