Abstract Details

Title Long term survival and 9-year follow-up of 14 HIV-infected adults with Progressive Multifocal Leucoencephalopathy

Topic Infectious Disease

Presentation(s) P10 - Poster Session 10 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-016

Objective We report on the long-term outcomes of a cohort of patients who developed PML in the setting of HIV.

Background

The mean survival of HIV-infected patients who develop progressive multifocal leukoencephalopathy (PML) is reported at 1.8 years. There is scarcity of data on long-term outcomes of this population of patients.

Design/Methods A cohort of 14 HIV-infected patients with a mean survival of 8 years and 8 months after their diagnosis with PML was studied in a retrospective chart-review manner.

Results Of this 14-patient cohort, 10 (71%) were males, the mean age at the time of conduction of this analysis in January 2017 was 51 years, the mean age at the time of their diagnosis with HIV was 35 years and at the time of their PML diagnosis was 42 years. CD4 count was >200 cells/mm³at the time of developing PML in 4(29%) patients whose mean survival thus far is 158 months (median 159.5, range 110-204), while the remaining 10 patients have a mean survival of 83 months (median 58, range 18-180) thus far. CSF showed pleocytosis in 3 of these 4 patients, but in only 2 of the remaining 10. Cognitive deficits were observed in 6/14(43%); focal sensory deficits in 5/14(36%); focal motor deficits in 4/14(29%); and visual field deficits in 2/14(14%). Deficits showed no significant clinical improvement. PML was the presenting manifestation of HIV infection in 3/14(21%) patients.

Conclusions Based on this small study population, long term survival after PML is not uncommon. Clinical deficits do not show clinically significant improvement even with long-term follow-up. Cortical symptoms such as aphasia, seizures, dysgraphia and dyslexia can occur. Patients with CD4 counts >200 cells/mm³, i.e. not meeting the AIDS definition, can develop PML.

Authors/Disclosures
Mahmoud A. AbdelRazek, MD (Wake Forest U / Atrium Neuroscience Institute) PRESENTER	Dr. AbdelRazek has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. AbdelRazek has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. AbdelRazek has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG therapeutics.
Golnaz Yadollahikhales, MD	Dr. Yadollahikhales has nothing to disclose.
	No disclosure on file
Aya A. Ouf, MBBS	Dr. Ouf has nothing to disclose.
Nagagopal Venna, MBBS, F�鶹��ýӳ�� (Massachusetts General Hospital)	Dr. Venna has nothing to disclose.

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