{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T21:51:55Z","timestamp":1761947515835},"reference-count":25,"publisher":"FapUNIFESP (SciELO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Inst. Med. trop. S. Paulo"],"published-print":{"date-parts":[[2008,8]]},"abstract":"<jats:p>Few data are available about progressive multifocal leukoencephalopathy (PML) in patients with acquired immunodeficiency syndrome (AIDS) from Brazil. The objectives of this study were to describe the main features of patients with PML and estimate its frequency among AIDS patients with central nervous system (CNS) opportunistic diseases admitted to the Instituto de Infectologia Em\u00edlio Ribas, S\u00e3o Paulo, Brazil, from April 2003 to April 2004. A retrospective and descriptive study was performed. Twelve (6%) cases of PML were identified among 219 patients with neurological diseases. The median age of patients with PML was 36 years and nine (75%) were men. Nine (75%) patients were not on antiretroviral therapy at admission. The most common clinical manifestations were: focal weakness (75%), speech disturbances (58%), visual disturbances (42%), cognitive dysfunction (42%), and impaired coordination (42%). The median CD4+ T-cell count was 45 cells\/\u00b5L. Eight (67%) of 12 patients were laboratory-confirmed with PML and four (33%) were possible cases. Eleven (92%) presented classic PML and only one case had immune reconstitution inflammatory syndrome (IRIS)-related PML. In four (33%) patients, PML was the first AIDS-defining illness. During hospitalization, three patients (25%) died as a result of nosocomial pneumonia and nine (75%) were discharged to home. Cases of PML were only exceeded by cases of cerebral toxoplasmosis, cryptococcal meningoencephalitis, and CNS tuberculosis, the three more frequent neurologic opportunistic infections in Brazil. The results of this study suggest that PML is not an uncommon HIV-related neurologic disorder in a referral center in Brazil.<\/jats:p>","DOI":"10.1590\/s0036-46652008000400004","type":"journal-article","created":{"date-parts":[[2008,9,29]],"date-time":"2008-09-29T14:47:01Z","timestamp":1222699621000},"page":"209-212","source":"Crossref","is-referenced-by-count":29,"title":["Aids-related progressive multifocal leukoencephalopathy: a retrospective study in a referral center in S\u00e3o Paulo, Brazil"],"prefix":"10.1590","volume":"50","author":[{"given":"Jos\u00e9 E.","family":"Vidal","sequence":"first","affiliation":[{"name":"Instituto de Infectologia Em\u00edlio Ribas,  Brasil; Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Augusto C. Penalva de","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Instituto de Infectologia Em\u00edlio Ribas,  Brasil; Universidade de Campinas,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Cristina D. S.","family":"Fink","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cl\u00e1udio S.","family":"Pannuti","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Roberto","family":"Trujillo","sequence":"additional","affiliation":[{"name":"University of Maryland,  USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1080\/13550280390195261","article-title":"Progressive multifocal leukoencephalopathy in acquired immunodeficiency syndrome: explaining the high incidence and disproportionate frequency of the illness relative to other immunosuppressive conditions","volume":"9","author":"BERGER J.R.","year":"2003","journal-title":"J. Neurovirol."},{"key":"ref2","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1111\/j.1365-2990.1992.tb00815.x","article-title":"Pathology of the central nervous system in patients infected with the human immunodeficiency virus (HIV): a report of 252 autopsy cases from Brazil","volume":"18","author":"CHIMELLI L.","year":"1992","journal-title":"Neuropath. appl. Neurobiol."},{"key":"ref3","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1080\/13550280390195351","article-title":"The effect of highly active antiretroviral therapy-induced immune reconstitution on development and outcome of progressive multifocal leukoencephalopathy: study of 43 cases with review of the literature","volume":"9","author":"CINQUE P.","year":"2003","journal-title":"J. Neurovirol."},{"key":"ref4","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1080\/13550280390195298","article-title":"The evolving face of human immunodeficiency virus-related progressive multifocal leukoencephalopathy: defining a consensus terminology","volume":"9","author":"CINQUE P.","year":"2003","journal-title":"J. Neurovirol."},{"key":"ref5","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1078\/0344-0338-00500","article-title":"Autopsy findings in AIDS patients from a reference hospital in Brazil: analysis of 92 cases","volume":"199","author":"CURY P.M.","year":"2003","journal-title":"Path. Res. Pract."},{"key":"ref6","first-page":"320","article-title":"Changing incidence of central nervous system diseases in the EuroSIDA cohort","volume":"55","author":"D'ARMINIO MONFORTE A.","year":"2004","journal-title":"Neurol."},{"key":"ref7","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.jinf.2005.02.015","article-title":"JC virus DNA in cerebrospinal fluid samples from Brazilian AIDS patients with focal brain lesions without mass effect","volume":"52","author":"FINK M.C.","year":"2006","journal-title":"J. Infect."},{"key":"ref8","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/S0188-4409(00)00067-9","article-title":"The clinical spectrum of neurological manifestations in AIDS patients in Mexico","volume":"31","author":"G\u00d3NGORA-RIVERA F.","year":"2000","journal-title":"Arch. med. Res.","ISSN":"http:\/\/id.crossref.org\/issn\/0188-0128","issn-type":"print"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1097\/00019052-200406000-00019","article-title":"New insights into progressive multifocal leukoencephalopathy","volume":"17","author":"KORALNIK I.J.","year":"2004","journal-title":"Curr. Opin. Neurol."},{"key":"ref10","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1002\/ana.20933","article-title":"Progressive multifocal leukoencephalopathy revisited: has the disease outgrown its name?","volume":"60","author":"KORALNIK I.J.","year":"2006","journal-title":"Ann. Neurol."},{"key":"ref11","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1097\/00002030-199803000-00009","article-title":"Profile of central nervous system pathology in patients with AIDS: an autopsy study from India","volume":"12","author":"LANJEWAR","year":"1998","journal-title":"AIDS","ISSN":"http:\/\/id.crossref.org\/issn\/0269-9370","issn-type":"print"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1097\/00002030-199312000-00005","article-title":"The mortality and pathology of HIV infection in a West African city","volume":"7","author":"LUCAS S.B.","year":"1993","journal-title":"AIDS","ISSN":"http:\/\/id.crossref.org\/issn\/0269-9370","issn-type":"print"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1590\/S0036-46652004000400005","article-title":"Chagasic meningoencephalitis: case report of a recently included AIDS-defining illness in Brazil","volume":"46","author":"MADALOSSO G.","year":"2004","journal-title":"Rev. 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Paulo)"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"671","DOI":"10.2165\/00023210-200519080-00003","article-title":"AIDS-associated progressive multifocal leukoencephalopathy: current management strategies","volume":"19","author":"ROBERTS M.T.","year":"2005","journal-title":"CNS Drugs","ISSN":"http:\/\/id.crossref.org\/issn\/1172-7047","issn-type":"print"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/0022-510X(86)90168-1","article-title":"Neuropathology of acquired immunodeficiency syndrome (AIDS): Analysis of 22 Brazilian cases","volume":"76","author":"ROSEMBERG S.","year":"1986","journal-title":"J. neurol. Sci."},{"key":"ref21","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1080\/13550280290101094","article-title":"The epidemiology of human immunodeficiency virus-associated neurological disease in the era of highly active antiretroviral therapy","volume":"8","author":"SACKTOR N.","year":"2002","journal-title":"J. Neurovirol."},{"key":"ref22","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1080\/13550280390195397","article-title":"Low prevalence of progressive multifocal leukoencephalopathy in India and Africa: is there a biological explanation?","volume":"9","author":"SHANKAR S.K.","year":"2003","journal-title":"J. Neurovirol."},{"key":"ref23","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/1742-6405-4-13","article-title":"BK virus associated meningoencephalitis in an AIDS patient treated with HAART","volume":"4","author":"VIDAL J.E.","year":"2007","journal-title":"AIDS Res. Ther."},{"key":"ref24","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1089\/apc.2005.19.626","article-title":"Cerebral toxoplasmosis in HIV-positive patients in Brazil: clinical features and predictors of treatment responser in the HAART era","volume":"19","author":"VIDAL J.E.","year":"2005","journal-title":"AIDS Patient Care and STDS","ISSN":"http:\/\/id.crossref.org\/issn\/1087-2914","issn-type":"print"},{"key":"ref25","first-page":"95","article-title":"The neuropathological findings in the acquired immunodeficiency syndrome (AIDS): a review of 138 cases","volume":"25","author":"WAINSTEIN M.","year":"1992","journal-title":"Rev. Soc. bras. 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