{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:25:34Z","timestamp":1761823534708},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,12,6]],"date-time":"2012-12-06T00:00:00Z","timestamp":1354752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2013,5]]},"abstract":"Objectives<\/jats:title>The aim of the study was to investigate whether survival after progressive multifocal leukoencephalopathy (PML<\/jats:styled-content>) diagnosis in HIV<\/jats:styled-content>\u20101\u2010infected patients was associated with central nervous system penetration\u2010effectiveness (CPE<\/jats:styled-content>) score and the presence or absence of protease inhibitors in the treatment regimen.<\/jats:p><\/jats:sec>Methods<\/jats:title>I<\/jats:styled-content>n the absence of treatments demonstrated to be effective for PML<\/jats:styled-content> in HIV<\/jats:styled-content>\u20101\u2010infected patients and in the light of the controversy surrounding the use of CPE<\/jats:styled-content> scores to make decisions on treatment after diagnosis, we determined whether there were differences in survival at 1 year depending on the type and characteristics of treatment. A multicentre retrospective observational study including three S<\/jats:styled-content>panish hospitals was carried out for the period from 1 J<\/jats:styled-content>anuary 1994 to 31 D<\/jats:styled-content>ecember 2009. Patients with a PML<\/jats:styled-content> diagnosis were included in the study if they were symptomatic and met at least two of the following three criteria: (1) compatible radiological findings; (2) a positive polymerase chain reaction for J<\/jats:styled-content>ohn C<\/jats:styled-content>unningham virus (JCV<\/jats:styled-content>) in the cerebrospinal fluid (CSF<\/jats:styled-content>); (3) an absence of findings suggesting another infection in the central nervous system, after general CSF<\/jats:styled-content> cultures for virus, bacteria and mycobacteria.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 98 patients were included in the study; 24.5% were diagnosed in the period 1994\u20131999, 39.8% in 2000\u20132004 and 35.7% in 2005\u20132009. The median follow\u2010up time was 363 days (interquartile range 108\u20131946 days). The median CD<\/jats:styled-content>4 count was 76 cells\/uL (interquartile range 30\u2013166 cells\/uL) and 62% of patients had an HIV<\/jats:styled-content> viral load >50 HIV<\/jats:styled-content>\u20101 RNA<\/jats:styled-content> copies\/ml. Thirty\u2010eight per cent of patients received high\u2010penetrance treatment, and 58% received treatment that included protease inhibitors. In the analysis of survival at 1 year, a higher CPE<\/jats:styled-content> score did not result in an improvement in survival, but the presence of protease inhibitors in the regimen was associated with a statistically significant (P<\/jats:italic>\u2009=\u20090.03) reduction in mortality (hazard ratio 0.40; 95% confidence interval 0.18\u20130.91).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>We consider that the lower mortality observed in the protease inhibitor group may be clinically relevant, and, if this is the case, a treatment based on protease inhibitors may be indicated for patients diagnosed with PML.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12008","type":"journal-article","created":{"date-parts":[[2012,12,7]],"date-time":"2012-12-07T05:12:55Z","timestamp":1354857175000},"page":"321-325","source":"Crossref","is-referenced-by-count":12,"title":["Evaluation of progressive multifocal leukoencephalopathy treatments in a S<\/scp>panish cohort of HIV<\/scp>\u2010infected patients: do protease inhibitors improve survival regardless of central nervous system penetration\u2010effectiveness (CPE<\/scp>) score?"],"prefix":"10.1111","volume":"14","author":[{"given":"F","family":"Fanjul","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Hospital Universitario Son Espases Carretera de Valldemosa SN Palma de Mallorca Illes Balears Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Riveiro\u2010Barciela","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department Hospital Universitari Vall d'Hebron Universitat Aut\u00f3noma de Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Hospital Son Llatzer Palma de Mallorca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Delgado","sequence":"additional","affiliation":[{"name":"Hospital Universitario Son Espases Palma de Mallorca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Murillas","sequence":"additional","affiliation":[{"name":"Hospital Universitario Son Espases Palma de Mallorca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Payeras Cifr\u00e9","sequence":"additional","affiliation":[{"name":"Internal Medicine Hospital Son Llatzer Palma de Mallorca Baleares Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V","family":"Falc\u00f3","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department Hospital Vall d'Hebron Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Riera","sequence":"additional","affiliation":[{"name":"Infectious Diseases Hospital Universitario Son Espases Palma de Mallorca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,12,6]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.10827"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-10-186999"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/713831540"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199805073381903"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32830a5043"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/13550280152537238"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000191322.93310.a1"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2008.557"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32832dc041"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32832c4152"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31820c3089"},{"key":"e_1_2_5_13_1","unstructured":"GasnaultJ LanoyE BentataM GuiguetM CostagliolaD.Intracerebral penetrating ART are more effi cient on survival of HIV+ patients with progressive multifocal leucoencephalopathy (ANRS CO4\u2014FHDH).15thConference on Retroviruses and Opportunistic Infections. 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