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Clinical and virological monitoring during treatment with intrathecal cytarabine in patients with AIDS-associated progressive multifocal leukoencephalopathy.

Authors :
De Luca A
Giancola ML
Cingolani A
Ammassari A
Gillini L
Murri R
Antinori A
Source :
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 1999 Mar; Vol. 28 (3), pp. 624-8.
Publication Year :
1999

Abstract

We describe the clinical and virological outcome of human immunodeficiency virus-infected patients with progressive multifocal leukoencephalopathy (PML) treated with cytarabine. Twenty-seven patients received intrathecal cytarabine, 5 received concomitant intravenous cytarabine, and 20 received concomitant antiretroviral therapy. The median baseline CD4+ cell count was 28/mm3. After 4 weeks, 4 (19%) of 21 evaluable patients had stable disease, whereas the others progressed. The median survival from diagnosis and from onset was 66 and 128 days, respectively. Patients with Karnofsky scores of >50 and those previously taking antiretroviral medications had a higher probability of survival 3 months after diagnosis (P = .003 and P = .05, respectively). Overall, after 4 weeks, median JC virus load in CSF increased by 0.7 log10 copies/mL from baseline (P = NS). The mean JC virus load at 4 weeks was lower in patients with stable disease than in progressors (3.47 vs. 4.47 log10 copies/mL; P = .027). JC virus became undetectable in the only patient who had a long-term stable condition. The concentration of JC virus in CSF showed a correlation with clinical outcome.

Details

Language :
English
ISSN :
1058-4838
Volume :
28
Issue :
3
Database :
MEDLINE
Journal :
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Publication Type :
Academic Journal
Accession number :
10194089
Full Text :
https://doi.org/10.1086/515153