Long-term prognosis and mortality in patients with progressive multifocal leukoencephalopathy.

배경: This study aimed to investigate the prognosis and prognostic factors for mortality in progressive multifocal leukoencephalopathy (PML) patients through a long observation period. 방법: This retrospective study was conducted in two tertiary hospitals in South Korea from 1999 to 2021. Patients diagnosed with PML were reviewed according to the American Academy of Neurology diagnostic criteria. The primary endpoint was long-term overall mortality. Each patient was followed up till death or the end of the study period. 결과: Total of 47 PML patients were included. Of 27 patients (57.4%) were diagnosed with HIV. Median last follow-up modified Rankin Scale (mRS) score was higher in the non-HIV PML group than that in the HIV group (5 vs. 4, p=0.020). Median survival duration was lower in the non-HIV group (184 vs. 1,564 days). The 1-year and overall mortality rates of PML patients were significantly higher in the non-HIV group than that in HIV group (60.0% vs. 25.9%, p=0.019; 80.0% vs. 40.7%, p=0.007). Initial mRS score (HR 1.685, p=0.038) and highly active antiretroviral therapy (HAART) in HIV patients (HR 0.374, p=0.013) had a significant effect on overall mortality. 결론: Survival duration of HIV-positive PML patients receiving HAART improved; however, the mortality rate is still high. Introduction of HAART in HIV patients and initial mRS score are significant prognostic factors for overall mortality in PML patients. [ABSTRACT FROM AUTHOR]