{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:14:49Z","timestamp":1790234089135,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,2,23]],"date-time":"2016-02-23T00:00:00Z","timestamp":1456185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2016,5]]},"abstract":"\n Background and purpose<\/jats:title>\n \n Progressive multifocal leucoencephalopathy\u2010associated immune reconstitution inflammatory syndrome (\n PML<\/jats:styled-content>\n \u2010\n IRIS<\/jats:styled-content>\n ) is the paradoxical worsening or unmasking of preexisting infection with\n JC<\/jats:styled-content>\n virus attributable to a rapid recovery of the immune system after highly active antiretroviral therapy (\n HAART<\/jats:styled-content>\n ) initiation. We investigated the incidence and factors associated with\n PML<\/jats:styled-content>\n \u2010\n IRIS<\/jats:styled-content>\n in\n HIV<\/jats:styled-content>\n \u2010infected patients. We also studied its influence on mortality of\n PML<\/jats:styled-content>\n and the effect of corticosteroid therapy.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Single\u2010center retrospective analysis of\n HIV<\/jats:styled-content>\n \u2010infected patients diagnosed with\n PML<\/jats:styled-content>\n from 1996 to 2012 who received\n HAART<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 59\n PML<\/jats:styled-content>\n patients treated with\n HAART<\/jats:styled-content>\n , 18 (30.51%) developed\n PML<\/jats:styled-content>\n \u2010\n IRIS<\/jats:styled-content>\n (five delayed\n PML<\/jats:styled-content>\n \u2010\n IRIS<\/jats:styled-content>\n , 13 simultaneous\n PML<\/jats:styled-content>\n \u2010\n IRIS<\/jats:styled-content>\n ). Patients who developed\n IRIS<\/jats:styled-content>\n had lower\n CD<\/jats:styled-content>\n 4 counts prior to treatment (102 vs. 68.5,\n P<\/jats:italic>\n < 0.05) and experienced a greater decline in\n HIV<\/jats:styled-content>\n \u2010\n RNA<\/jats:styled-content>\n levels in response to\n HAART<\/jats:styled-content>\n (2.5log vs. 2.95log,\n P<\/jats:italic>\n < 0.05). Gadolinium enhancement on\n MRI<\/jats:styled-content>\n was observed in 31.25% of\n PML<\/jats:styled-content>\n \u2010\n IRIS<\/jats:styled-content>\n cases versus 2.56% of\n PML<\/jats:styled-content>\n non\u2010\n IRIS<\/jats:styled-content>\n (\n P<\/jats:italic>\n < 0.01). Survival rates were higher in patients with\n PML<\/jats:styled-content>\n \u2010\n IRIS<\/jats:styled-content>\n compared to those with\n PML<\/jats:styled-content>\n non\u2010\n IRIS<\/jats:styled-content>\n . Eight patients received corticosteroids, five of which had a good outcome. Patients who died were severely ill when treatment was initiated whereas patients who survived were treated before major neurological deterioration occurred.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Nearly one\u2010third of\n HIV<\/jats:styled-content>\n \u2010infected patients with\n PML<\/jats:styled-content>\n develop\n IRIS<\/jats:styled-content>\n after initiating\n HAART<\/jats:styled-content>\n . Patients severely immunocompromised who experience a rapid virological response to\n HAART<\/jats:styled-content>\n have a higher risk for\n PML<\/jats:styled-content>\n \u2010\n IRIS<\/jats:styled-content>\n . There was a trend for lower mortality in patients with\n IRIS<\/jats:styled-content>\n . Early treatment with corticosteroids might be useful.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ene.12963","type":"journal-article","created":{"date-parts":[[2016,2,25]],"date-time":"2016-02-25T21:20:44Z","timestamp":1456435244000},"page":"919-925","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Incidence and prognosis of immune reconstitution inflammatory syndrome in HIV\u2010associated progressive multifocal leucoencephalopathy"],"prefix":"10.1111","volume":"23","author":[{"given":"S.","family":"Sainz\u2010de\u2010la\u2010Maza","sequence":"first","affiliation":[{"name":"Department of Neurology Hospital Universitario Ram\u00f3n y Cajal Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. L.","family":"Casado","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Hospital Universitario Ram\u00f3n y Cajal Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. J.","family":"P\u00e9rez\u2010El\u00edas","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Hospital Universitario Ram\u00f3n y Cajal Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Hospital Universitario Ram\u00f3n y Cajal Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Quereda","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Hospital Universitario Ram\u00f3n y Cajal Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Hospital Universitario Ram\u00f3n y Cajal Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Corral","sequence":"additional","affiliation":[{"name":"Department of Neurology Hospital Universitario Ram\u00f3n y Cajal Madrid 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