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Sub-Category:

Demyelinating Disorders

Number of Conditions: 1

Progressive Multifocal Leukoencephalopathy (PML) in HIV

Specialty: Infectious Diseases

Category: Neurological Complications of HIV

Sub-category: Demyelinating Disorders

Symptoms:
progressive weakness; visual disturbances; difficulty speaking; cognitive decline; ataxia; seizures

Root Cause:
Reactivation of JC virus in the central nervous system due to immunosuppression, leading to demyelination of nerve cells.

How it's Diagnosed: videos
MRI brain imaging showing white matter lesions, CSF analysis for JC virus DNA via PCR, and clinical evaluation.

Treatment:
Initiation or optimization of ART to restore immune function, and supportive care to manage neurological symptoms.

Medications:
No direct antiviral treatment for JC virus; management focuses on restoring immune function with ART. Investigational therapies include immune checkpoint inhibitors or antiviral agents like brincidofovir (investigational).

Prevalence: How common the health condition is within a specific population.
Occurs in 1-5% of HIV-positive individuals, more common in those with advanced immunosuppression (CD4 < 200 cells/mm³).

Risk Factors: Factors or behaviors that increase the likelihood of developing the condition.
Advanced HIV, low CD4 count, prior opportunistic infections, and suboptimal ART adherence.

Prognosis: The expected outcome or course of the condition over time.
Guarded; survival has improved with ART, but residual neurological deficits are common.

Complications: Additional problems or conditions that may arise as a result of the original condition.
Severe neurological disability, seizures, and increased mortality.