Clinical analysis on HIV-associated progressive multifocal leukoencephalopathy: report of four probable cases

Abstract

Objective To summarize the clinical manifestations, laboratory and MRI examinations, treatment and prognosis of 4 patients with human immunodeficiency virus (HIV)-associated progressive multifocal leukoencephalopathy (PML).  Methods The clinical data of 4 patients with HIV-associated PML was retrospectively analyzed. Results All of the 4 cases presented with progressive neurological function deficit and limb weakness. One case was accompanied by dysphasia, and one by dizziness. These symptoms got worsened as time went on. Cranial MRI revealed demyelination, hypointense signal in T₁WI, hyperintense signal in T₂WI and FLAIR. DWI revealed central hypointense and peripheral hyperintense signal. Enhanced scan revealed no contrast enhancement. Two cases were treated with highly active antiretroviral therapy (HAART), and the longest survival was 20 months. Patients who did not take standard anti-HIV therapies had a poor long-term prognosis. Conclusions Patients with HIV-associated PML mainly present progressively worsened neurological function deficit. The imaging manifestations are typical. Early and timely HAART may play a role in the treatment.

DOI: 10.3969/j.issn.1672-6731.2016.08.005