Article
Clinical Neurology
D. Mickeviciene, A. Baltusiene, B. Afanasjeva, D. Afanasjevas, R. Gleizniene, D. Rastenyte, Jr. Berger
Summary: This case report highlights the importance of careful monitoring of patients after discontinuation of fingolimod for PML-IRIS and distinguishing between PML-IRIS and rebound MS with IRIS.
Article
Clinical Neurology
Marine Joly, Cecile Conte, Charles Cazanave, Vincent Le Moing, Pierre Tattevin, Pierre Delobel, Agnes Sommet, Guillaume Martin-Blondel
Summary: This study examined the epidemiology and prognosis of progressive multifocal leukoencephalopathy using a large cohort of patients in France. The findings revealed a stable incidence rate of the disease in France, with HIV infection being the main predisposing condition. Male patients had a higher risk of mortality compared to females, and patients with solid neoplasms had the worst prognosis.
Article
Clinical Neurology
Xavier Boumaza, Baptiste Bonneau, Damien Roos-Weil, Carmela Pinnetti, Sebastian Rauer, Louisa Nitsch, Arnaud Del Bello, Ilijas Jelcic, Kurt-Wolfram Suehs, Jacques Gasnault, Yasemin Goreci, Oliver Grauer, Sharmilee Gnanapavan, Rebecca Wicklein, Nicolas Lambert, Thomas Perpoint, Martijn Beudel, David Clifford, Agnes Sommet, Irene Cortese, Guillaume Martin-Blondel
Summary: This study aimed to evaluate the real-world effectiveness of immune checkpoint inhibitors in the treatment of patients with progressive multifocal leukoencephalopathy (PML). Retrospective data from 79 PML patients who received immune checkpoint inhibitors were analyzed, and the results showed that mortality remained high and the development of inflammatory features or PML-IRIS was commonly observed. The study highlights the importance of personalized use of immune checkpoint inhibitors for PML patients.
ANNALS OF NEUROLOGY
(2023)
Review
Clinical Neurology
Nora Moehn, Lea Grote-Levi, Franziska Hopfner, Britta Eiz-Vesper, Britta Maecker-Kolhoff, Clemens Warnke, Kurt-Wolfram Suehs, Mike P. Wattjes, Guenter U. Hoeglinger, Thomas Skripuletz
Summary: Progressive multifocal leukoencephalopathy (PML) is an opportunistic viral disease of the brain caused by human polyomavirus 2. It affects patients with compromised immune systems and currently has no effective treatment. The primary therapeutic strategy focuses on reconstituting the immune system, with recent studies showing promising effects with anti-PD-1 antibodies and allogeneic virus-specific T cells.
JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Gautier Breville, Igor J. Koralnik, Patrice H. Lalive
Summary: Isolated brainstem lesions at disease onset are extremely rare in PML cases, with most patients experiencing initial clinical worsening. However, some patients may achieve full or partial recovery despite the reserved prognosis due to the vital structures in the brainstem.
EUROPEAN JOURNAL OF NEUROLOGY
(2021)
Article
Clinical Neurology
Nicolas Lambert, Majdouline El Moussaoui, Pierre Maquet
Summary: This study investigated the response of patients with Progressive multifocal leukoencephalopathy (PML) to immune checkpoint inhibitors (ICI). It was found that a history of therapeutic immune suppression and the use of an immunosuppressive therapy at treatment initiation were significantly associated with a poor response. Reaching an undetectable viral load in the cerebrospinal fluid and reduction of lesion load on magnetic resonance imaging after ICI administration were associated with a good clinical response.
EUROPEAN JOURNAL OF NEUROLOGY
(2021)
Review
Infectious Diseases
Sydney Corey, Bryan R. Smith, Irene C. M. Cortese
Summary: This review discusses the importance of progressive multifocal leukoencephalopathy (PML) in people living with HIV and the potential of immune checkpoint blockade as a treatment strategy. Although the results from current studies are varied, checkpoint blockade has shown promising outcomes in a small subset of patients. However, the risk of immune reconstitution inflammatory syndrome remains a concern, highlighting the need for careful patient selection and monitoring.
CURRENT HIV/AIDS REPORTS
(2022)
Article
Clinical Neurology
Damien Roos-Weil, Nicolas Weiss, Amelie Guihot, Madalina Uzunov, Agnes Bellanger, Bruno Eymard, David Saadoun, Caroline Houillier, Ahmed Idbaih, Sophie Demeret, Claire Deback, Veronique Leblond, Damien Galanaud, Natalia Shor, Valerie Pourcher
Summary: This study reported the outcomes of six patients with progressive multifocal leukoencephalopathy (PML) treated with immune checkpoint inhibitors (ICI). The results showed that some patients were alive with follow-up, but some still died from PML, suggesting that ICI may be effective for PML treatment, but the efficacy was less impressive than previously reported. Further larger studies are needed to confirm this efficacy and identify predictive factors of response.
JOURNAL OF NEUROLOGY
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
Manel Alleg, Morgane Solis, Seyyid Baloglu, Francois Cotton, Philippe Kerschen, Bertrand Bourre, Guido Ahle, Jean-Pierre Pruvo, Xavier Leclerc, Patrick Vermersch, Caroline Papeix, Elisabeth Maillart, Caroline Houillier, Cecile Molucon Chabrot, Beatrice Claise, Sandra Malak, Guillaume Martin-Blondel, Fabrice Bonneville, Alexis Caulier, Jean-Pierre Marolleau, Jerome Tamburini Bonnefoy, Philippe Agape, Celine Kennel, Xavier Roussel, Adrien Chauchet, Jerome De Seze, Samira Fafi-Kremer, Stephane Kremer
Summary: The study compared brain MRI findings in PML associated with rituximab, natalizumab treatments, and HIV infection. Different imaging features were observed in the three types of PML, with natalizumab-associated PML showing more inflammatory signs and cortex involvement, while rituximab and HIV-associated PML exhibited milder contrast enhancement and punctuate appearance. The differences in MRI findings may be related to varying levels of immunosuppression in the different patient groups.
EUROPEAN RADIOLOGY
(2021)
Article
Microbiology
Paola Frattaroli, Teresa A. Chueng, Obinna Abaribe, Folusakin Ayoade
Summary: Progressive multifocal leukoencephalopathy (PML) can complicate antiretroviral therapy (ART) in individuals living with HIV, presenting as immune reconstitution inflammatory syndrome (IRIS). The manifestation of PML can be simultaneous or delayed worsening, with a rare occurrence of cerebellar involvement. Steroids may be considered as a treatment option, but the optimal duration remains unclear.
Article
Immunology
Ran Tao, Xiaorong Peng, Xiang Liu, Junwei Su, Guanjing Lang, Ying Huang, Yafei Zhang, Biao Zhu
Summary: Cryptococcal meningitis (CM) is a common opportunistic infection in HIV patients. This study reports two cases of CM-associated immune reconstitution inflammatory syndrome (IRIS) treated with lenalidomide, which resulted in rapid clinical remission and improved cognitive function. The study also suggests that lenalidomide may improve cognitive function by regulating intracranial inflammation through multiple pathways, not just by TNF-α blocking.
JOURNAL OF INFLAMMATION RESEARCH
(2022)
Article
Immunology
Luxin Pei, Kiyoshi F. Fukutani, Rafael Tiburcio, Adam Rupert, Eric W. Dahlstrom, Frances Galindo, Elizabeth Laidlaw, Andrea Lisco, Maura Manion, Bruno B. Andrade, Irini Sereti
Summary: The study identified metabolic disturbances in IRIS before and during the event, linking oxidative stress, tryptophan pathway, and lipid signaling with IRIS development. Metabolic pathways of lipids and amino acids were significantly associated with inflammatory biomarkers like IL-12p70 and IL-8 during the IRIS event, suggesting the impact of cellular metabolism on immune cell activation and vice versa.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Immunology
Caian L. Vinhaes, Virginia Sheikh, Deivide Oliveira-de-Souza, Jing Wang, Adam Rupert, Gregg Roby, Maria B. Arriaga, Kiyoshi F. Fukutani, Fred Sawe, Doug Shaffer, Jintanat Ananworanich, Nittaya Phanuphak, Bruno B. Andrade, Irini Sereti
Summary: The study found that systemic inflammatory profiles in people with severe immunosuppression can predict the development of immune reconstitution inflammatory syndrome (IRIS). By developing a composite score incorporating various biomarkers, including interleukin-6, IL-10, IL-27, sCD14, interferon-gamma, tumor necrosis factor-alpha, hyaluronic acid, D-dimer, body mass index, and hemoglobin, accurate predictions of IRIS occurrence and death risk can be made.
JOURNAL OF INFECTIOUS DISEASES
(2021)
Review
Clinical Neurology
Neetu Soni, Manish Ora, Rajiv Mangla, Rohit Singh, Shehanaz Ellika, Amit Agarwal, Steven P. Meyers, Girish Bathla
Summary: Progressive multifocal leukoencephalopathy (PML) is a rare viral central nervous system (CNS) demyelinating disease associated with compromised immune system. It mainly occurs in individuals with HIV, lymphoproliferative disease, and multiple sclerosis, as well as patients on immunomodulators, chemotherapy, and organ or bone marrow transplants. Early recognition of typical and atypical imaging abnormalities in PML is crucial in high-risk populations for early diagnosis and differentiation from other conditions. This review provides a practical overview of radiological abnormalities in PML patients to aid in differential considerations.
MULTIPLE SCLEROSIS AND RELATED DISORDERS
(2023)
Article
Immunology
Joseph M. Rocco, Elizabeth Laidlaw, Frances Galindo, Megan Anderson, Adam Rupert, Jeanette Higgins, Ornella Sortino, Ana M. Ortega-Villa, Virginia Sheikh, Gregg Roby, Safia Kuriakose, Andrea Lisco, Maura Manion, Irini Sereti
Summary: Severe mycobacterial IRIS in HIV can cause secondary HLH driven by pathologic IFN gamma production and T-cell activation, leading to worse outcomes. Increased ferritin, anemia, CXCL9, and sCD25 associate with this phenotype and may be used for risk stratification and treatment optimization.
CLINICAL INFECTIOUS DISEASES
(2023)
Review
Immunology
Yuani M. Roman, Paula Alejandra Burela, Vinay Pasupuleti, Alejandro Piscoya, Jose E. Vidal, Adrian Hernandez
Summary: This systematic review found that in patients with mostly mild COVID-19, ivermectin did not reduce all-cause mortality, hospital stays, or viral clearance compared to the control group. Therefore, ivermectin is not a viable treatment option for COVID-19.
CLINICAL INFECTIOUS DISEASES
(2022)
Article
Immunology
Carlos Mejia-Chew, Peggy L. Carver, Sasinuch Rutjanawech, Luis F. Aranha Camargo, Ruan Fernandes, Sara Belga, Shay Anne Daniels, Nicolas J. Mueller, Sara Burkhard, Nicole M. Theodoropoulos, Douwe F. Postma, Pleun J. van Duijn, Maria Carmen Farinas, Claudia Gonzalez-Rico, Jonathan Hand, Adam Lowe, Marta Bodro, Elisa Vanino, Ana Fernandez Cruz, Antonio Ramos, Mateja Jankovic Makek, Ribal Bou Mjahed, Oriol Manuel, Nassim Kamar, Antonia Calvo-Cano, Laura Rueda Carrasco, Patricia Munoz, Sara Rodriguez, Sandra Perez-Recio, Nuria Sabe, Regino Rodriguez Alvarez, Jose Tiago Silva, Alessandra Mularoni, Elisa Vidal, Juana Alonso-Titos, Teresa del Rosal, Annika Y. Classen, Charles W. Goss, Mansi Agarwal, Francisco Lopez-Medrano
Summary: This study aimed to describe the risk factors for nontuberculous mycobacteria (NTM) infections after solid organ transplant (SOT). The results showed that older age, prior hospital admission, receipt of antifungals, and lymphocyte-specific antibodies were associated with NTM infection.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Immunology
Rodovaldo M. Lucas Junior, Giuliane Bogoni, Gustavo A. Reis Schneider, Nidyanara F. Castanheira de Souza, Maria Kassab Carvalho, Jose Ernesto Vidal
Summary: A study in Brazil found that the prevalence of cytomegalovirus encephalitis in HIV/AIDS patients was 2.4%, and 7.7% among patients with neurological opportunistic diseases. Most of the patients had a low CD4 cell count and were treated with antiviral therapy, resulting in successful discharge from the hospital.
INTERNATIONAL JOURNAL OF STD & AIDS
(2023)
Article
Immunology
Giuliane Bogoni, Rodovaldo M. Lucas Junior, Gustavo Arthur Reis Schneider, Nidyanara F. Castanheira de Souza, Maria Kassab Carvalho, Rosa Maria Marcusso, Jose Ernesto Vidal
Summary: This study aims to investigate the prevalence and characteristics of active cytomegalovirus (CMV) retinitis in severely immunosuppressed people living with HIV. The results show a low prevalence of active CMV retinitis in the evaluated population, but asymptomatic cases were still observed, highlighting the importance of routine ophthalmologic evaluation for severely immunosuppressed HIV patients.
INTERNATIONAL JOURNAL OF STD & AIDS
(2023)
Article
Infectious Diseases
Francelise Bridi Cavassin, Jose Ernesto Vidal, Joao Luiz Bau-Carneiro, Cassia Silva de Miranda Godoy, Renata de Bastos Ascenco Soares, Marcello Mihailenko Chaves Magri, Diego Rodrigues Falci, Carla Sakuma De Oliveira, Ana Verena Almeida Mendes, Giovanni Luis Breda, Caroline Martins Rego, Maira Araujo Felix, Paula Pacheco Katopodis, Julia Raquel da Silva do O, Mirela Pereira Lima Abrao, Mariane Taborda, Talita Teles Teixeira Pereira, Flavio Queiroz-Telles
Summary: This multicenter cohort study aimed to describe the characteristics, mortality, and associated variables of hospitalized patients with cryptococcosis in Brazil. It found that the disease is increasingly being identified in immunocompetent individuals and had a high in-hospital mortality rate. Understanding the epidemiology of cryptococcosis in different patient groups can help improve strategies to reduce mortality.
Article
Medicine, General & Internal
Barbara Labella Henriques, Jose Ernesto Vidal, Cristiano Gamba, Vivian Iida Avelino-Silva
Summary: This study investigated the knowledge, attitudes, and practices of infectious disease specialists and residents regarding the care of asymptomatic HIV-syphilis coinfection. The results showed that most participants believed that the criteria for lumbar puncture should be extended to PLHIV with low CD4+ cell counts, late latent syphilis, and VDRL titers >= 1:32.
SAO PAULO MEDICAL JOURNAL
(2023)
Article
Infectious Diseases
Alessandro C. Pasqualotto, Flavio Queiroz-Telles, Alberto Chebabo, Terezinha M. J. S. Leitao, Diego R. Falci, Melissa O. Xavier, Monica B. Bay, Eduardo Sprinz, Daiane Dalla Lana, Adriana P. Vincentini, Lisandra Serra Damasceno, Alexandre V. Schwarzbold, Paulo Abrao Ferreira, Cassia Miranda Godoy, Jose Ernesto Vidal, Rossana Basso, Candida Driemeyer, Valerio R. Aquino, Cecilia B. Severo, Marcelo Simao Ferreira, Claudilson Bastos, Filipe Prohaska, Marineide Melo, Francelise Bridi Cavassin, Marcus Lacerda, Renata Soares, Rosely Zancope-Oliveira, Marcus Teixeira, Freddy Perez, Diego H. Caceres, Juan Luis Rodriguez-Tudela, Tom Chiller, Arnaldo L. Colombo
PLOS NEGLECTED TROPICAL DISEASES
(2023)
Article
Infectious Diseases
Fernanda Gurgel Oliveira, Jeanne Aiko de Souza Nakagawa, Jefersson Matheus Maia de Oliveira, Rodovaldo Moraes Lucas Jr, Rosa Marcusso, Jose E. Vidal
Summary: Timely diagnosis is crucial in managing central nervous system cryptococcosis in people living with HIV/AIDS. This study evaluated the prevalence of CNS cryptococcosis and cryptococcal antigenemia using fingerprick whole-blood CrAg LFA in a referral emergency department in Sao Paulo, Brazil. The results showed a high prevalence of CNS cryptococcosis and cryptococcal antigenemia using this method, highlighting the importance of point-of-care testing for diagnosing CNS cryptococcosis.
Article
Biochemistry & Molecular Biology
Rodrigo Pessoa, Daniela Raguer Valadao de Souza, Youko Nukui, Juliana Pereira, Lorena Abreu Fernandes, Rosa Nascimento Marcusso, Augusto Cesar Penalva de Oliveira, Jorge Casseb, Alberto Jose da Silva Duarte, Sabri Saeed Sanabani
Summary: Small RNAs are important epigenetic regulators in leukemias, including adult T-cell leukemia/lymphoma (ATLL). This study investigates the sRNA profile of a 30-year-old woman with ATLL at diagnosis and after maintenance therapy to correlate expression levels with therapy response.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Microbiology
Flavia Esper Dahy, Tatiane Assone, Rosa M. N. Marcusso, Joao V. Luisi de Moura, Michel E. J. Haziot, Jose E. Vidal, Jerusa Smid, Augusto C. Penalva de Oliveira, Jorge Casseb
Summary: Our findings suggest that oral corticosteroids therapy may be beneficial as maintenance therapy for HTLV-1-associated myelopathy (HAM). The daily use of low-dose prednisone seems to help stabilize the progression of the disease in some subsets of HAM patients and should be further investigated in randomized controlled trials.
MICROBIOLOGY RESEARCH
(2023)
Article
Infectious Diseases
Jussemara Souza da Silva, Bruno Correia Ernandes, Carol Lee Luna Fernandes, Ademir Silva Correia, Cesar Cilento Ponce, Jaques Sztajnbok, Camila Rodrigues, Jose Ernesto Vidal
Summary: AIDS-related disseminated histoplasmosis (DH) can cause septic shock and multiorgan dysfunction, with a high mortality rate. This case report describes a 41-year-old male patient with advanced HIV disease presenting with sepsis, multiorgan dysfunction, and disseminated skin lesions. The patient was diagnosed with DH and received comprehensive management in the ICU, including antifungal therapy, mechanical ventilation, and hemodialysis. Early in-hospital diagnosis and treatment, as well as intensive care, were crucial for the patient's favorable outcome.
REVISTA DO INSTITUTO DE MEDICINA TROPICAL DE SAO PAULO
(2023)
