JC virus-associated central nervous system diseases in HIV-infected patients in Brazil: clinical presentations, associated factors with mortality and outcome
Braz. j. infect. dis
; 16(2): 153-156, May-Apr. 2012.
Artigo
em Inglês
| LILACS, Sec. Est. Saúde SP
| ID: lil-622736
Biblioteca responsável:
BR1.1
ABSTRACT
INTRODUCTION:
Several presentations of neurologic complications caused by JC virus (JCV) in human immunodeficiency virus (HIV)-infected patients have been described and need to be distinguished from the "classic" form of progressive multifocal leukoencephalopathy (PMl). The objectives of this study were 1) to describe the spectrum and frequency of presentations of JCV-associated central nervous system (CNS) diseases; 2) identify factors associated with in-hospital mortality of patients with JCV-associated CNS disease; and 3) to estimate the overall mortality of this population. MATERIAL ANDMETHODS:
This was a retrospective study of HIV-infected patients admitted consecutively for JCVassociated CNS diseases in a referral teaching center in São Paulo, Brazil, from 2002 to 2007. All patients with laboratory confirmed JCV-associated CNS diseases were included using the following criteria compatible clinical and radiological features associated with the presence of JCV DNA in the cerebrospinal fluid. JCV-associated CNS diseases were classified as follows 1) classic PMl; 2) inflammatory PMl; and 3) JC virus granule cell neuronopathy (GCN).RESULTS:
We included 47 cases. JCV-associated CNS diseases were classified as follows 1) classic PMl 42 (89%); 2) inflammatory PMl three (6%); and 3) JC virus GCN four (9%). Nosocomial pneumonia (p = 0.003), previous diagnosis of HIV infection (p = 0.03), and imaging showing cerebellar and/or brainstem involvement (p = 0.02) were associated with in-hospital mortality. overall mortality during hospitalization was 34%.CONCLUSIONS:
Novel presentations of JCV-associated CNS diseases were observed in our setting; nosocomial pneumonia, previous diagnosis of HIV infection, and cerebellar and/or brainstem involvement were associated with in-hospital mortality; and overall mortality was high.
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Brasil
Base de dados:
LILACS
/
Sec. Est. Saúde SP
Assunto principal:
Leucoencefalopatia Multifocal Progressiva
/
Infecções Oportunistas Relacionadas com a AIDS
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Adulto
/
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
América do Sul
/
Brasil
Idioma:
Inglês
Revista:
Braz. j. infect. dis
Ano de publicação:
2012
Tipo de documento:
Artigo
Instituição/País de afiliação:
Instituto de Infectologia Emílio Ribas/BR
/
Universidade de São Paulo/BR