Progressive multifocal leukoencephalopathy in HIV-infected patients: clinical features and diagnosis (literature review)

Progressive multifocal leukoencephalopathy (PML) is one of the most severe opportunistic diseases of the central nervous system, which leads to multiple demyelination of brain structures, neurological symptoms and frequent death or disability of the patient. The etiological factor of this disease is...

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Main Authors: E. A. Samotolkina, A. V. Pokrovskaya, S. V. Matosova, E. A. Domonova
Format: Article
Language:Russian
Published: Journal Infectology 2019-10-01
Series:Журнал инфектологии
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Online Access:https://journal.niidi.ru/jofin/article/view/925
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author E. A. Samotolkina
A. V. Pokrovskaya
S. V. Matosova
E. A. Domonova
author_facet E. A. Samotolkina
A. V. Pokrovskaya
S. V. Matosova
E. A. Domonova
author_sort E. A. Samotolkina
collection DOAJ
description Progressive multifocal leukoencephalopathy (PML) is one of the most severe opportunistic diseases of the central nervous system, which leads to multiple demyelination of brain structures, neurological symptoms and frequent death or disability of the patient. The etiological factor of this disease is Human polyomavirus 2 (JCPyV).This pathogen is widespread – antibodies are found in 80% of the world›s population. However, the clinical symptoms of this infection appear only in people with a pronounced decline in cellular immunity. Until 1980 progressive multifocal leukoencephalopathy was extremely rarely diagnosed. Now days the main cause of the clinical symptoms of PML is immunodeficiency caused by HIV infection. Clinical manifestations of PML are characterized by various non-specific neurological symptoms, similar to other lesions of the central nervous system, the symptoms progress slowly over several months, and usually lead to death. Diagnosis of PML is based on laboratory and instrumental methods, such as DNA JCPyV detection in the cerebrospinal fluid, brain biopsy, and radiation diagnostic methods. There is no effective prevention and etiotropic therapy for PML. Improved parameters of cellular immunity and antiretroviral treatment in HIV positive patients significantly increase the life expectancy of patients with PML. Despite the ability of drugs to prevent the progression of the disease, pathological changes in the brain are irreversible and lead to persistent disability of patients, therefore, it is necessary to diagnose PML in the early stages of the disease.
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spelling doaj-art-2c628717690e4ea095319bcd35e982092025-08-20T04:00:15ZrusJournal InfectologyЖурнал инфектологии2072-67322019-10-0111351210.22625/2072-6732-2019-11-3-5-12733Progressive multifocal leukoencephalopathy in HIV-infected patients: clinical features and diagnosis (literature review)E. A. Samotolkina0A. V. Pokrovskaya1S. V. Matosova2E. A. Domonova3Peoples’ Friendship University of RussiaPeoples’ Friendship University of Russia; Central Research Institute of Epidemiology of RospotrebnadzorCentral Research Institute of Epidemiology of RospotrebnadzorCentral Research Institute of Epidemiology of RospotrebnadzorProgressive multifocal leukoencephalopathy (PML) is one of the most severe opportunistic diseases of the central nervous system, which leads to multiple demyelination of brain structures, neurological symptoms and frequent death or disability of the patient. The etiological factor of this disease is Human polyomavirus 2 (JCPyV).This pathogen is widespread – antibodies are found in 80% of the world›s population. However, the clinical symptoms of this infection appear only in people with a pronounced decline in cellular immunity. Until 1980 progressive multifocal leukoencephalopathy was extremely rarely diagnosed. Now days the main cause of the clinical symptoms of PML is immunodeficiency caused by HIV infection. Clinical manifestations of PML are characterized by various non-specific neurological symptoms, similar to other lesions of the central nervous system, the symptoms progress slowly over several months, and usually lead to death. Diagnosis of PML is based on laboratory and instrumental methods, such as DNA JCPyV detection in the cerebrospinal fluid, brain biopsy, and radiation diagnostic methods. There is no effective prevention and etiotropic therapy for PML. Improved parameters of cellular immunity and antiretroviral treatment in HIV positive patients significantly increase the life expectancy of patients with PML. Despite the ability of drugs to prevent the progression of the disease, pathological changes in the brain are irreversible and lead to persistent disability of patients, therefore, it is necessary to diagnose PML in the early stages of the disease.https://journal.niidi.ru/jofin/article/view/925progressive multifocal leukoencephalopathyhiv infectionhuman polyomavirus 2jcpyvpml
spellingShingle E. A. Samotolkina
A. V. Pokrovskaya
S. V. Matosova
E. A. Domonova
Progressive multifocal leukoencephalopathy in HIV-infected patients: clinical features and diagnosis (literature review)
Журнал инфектологии
progressive multifocal leukoencephalopathy
hiv infection
human polyomavirus 2
jcpyv
pml
title Progressive multifocal leukoencephalopathy in HIV-infected patients: clinical features and diagnosis (literature review)
title_full Progressive multifocal leukoencephalopathy in HIV-infected patients: clinical features and diagnosis (literature review)
title_fullStr Progressive multifocal leukoencephalopathy in HIV-infected patients: clinical features and diagnosis (literature review)
title_full_unstemmed Progressive multifocal leukoencephalopathy in HIV-infected patients: clinical features and diagnosis (literature review)
title_short Progressive multifocal leukoencephalopathy in HIV-infected patients: clinical features and diagnosis (literature review)
title_sort progressive multifocal leukoencephalopathy in hiv infected patients clinical features and diagnosis literature review
topic progressive multifocal leukoencephalopathy
hiv infection
human polyomavirus 2
jcpyv
pml
url https://journal.niidi.ru/jofin/article/view/925
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AT avpokrovskaya progressivemultifocalleukoencephalopathyinhivinfectedpatientsclinicalfeaturesanddiagnosisliteraturereview
AT svmatosova progressivemultifocalleukoencephalopathyinhivinfectedpatientsclinicalfeaturesanddiagnosisliteraturereview
AT eadomonova progressivemultifocalleukoencephalopathyinhivinfectedpatientsclinicalfeaturesanddiagnosisliteraturereview