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Progressive multifocal leukoencephalopathy: Treatment and prognosis

INTRODUCTION

Progressive multifocal leukoencephalopathy (PML) is an often fatal demyelinating disease of the central nervous system that occurs almost exclusively in immunosuppressed individuals. This disease is caused by the polyomavirus JC (JCV).  (See "Epidemiology of JC and BK virus infection" and "Progressive multifocal leukoencephalopathy: Epidemiology, clinical manifestations, and diagnosis".)

This topic will review the various approaches that have been employed to treat PML. Other aspects of JC viral infection and PML are discussed elsewhere. (See "Epidemiology of JC and BK virus infection" and "Progressive multifocal leukoencephalopathy: Epidemiology, clinical manifestations, and diagnosis".)

APPROACH TO TREATMENT

There is no specific treatment for PML, which has a high mortality rate. Therefore, the main approach is restoring the host adaptive immune response, a strategy that appears to prolong survival [1,2]. Implementation of this strategy differs according to the clinical setting:

Initiating or optimizing effective antiretroviral therapy (ART) for patients with HIV infection

Withdrawing immunosuppressive drugs (when possible) for patients without HIV infection

              

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Literature review current through: Oct 2014. | This topic last updated: Jul 11, 2014.
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