%0 Journal Article
%T JC virus-associated central nervous system diseases in HIV-infected patients in Brazil: clinical presentations, associated factors with mortality and outcome
%A Piza
%A Felipe
%A Fink
%A Maria Cristina
%A Nogueira
%A Gilberto S.
%A Pannuti
%A Claudio S.
%A Oliveira
%A Augusto C. Penalva de
%A Vidal
%A Jos¨¦ Ernesto
%J Brazilian Journal of Infectious Diseases
%D 2012
%I Brazilian Society of Infectious Diseases
%R 10.1590/S1413-86702012000200008
%X introduction: several presentations of neurologic complications caused by jc virus (jcv) in human immunodeficiency virus (hiv)-infected patients have been described and need to be distinguished from the "classic" form of progressive multifocal leukoencephalopathy (pml). the objectives of this study were: 1) to describe the spectrum and frequency of presentations of jcv-associated central nervous system (cns) diseases; 2) identify factors associated with in-hospital mortality of patients with jcv-associated cns disease; and 3) to estimate the overall mortality of this population. material and methods: this was a retrospective study of hiv-infected patients admitted consecutively for jcvassociated cns diseases in a referral teaching center in s£¿o paulo, brazil, from 2002 to 2007. all patients with laboratory confirmed jcv-associated cns diseases were included using the following criteria: compatible clinical and radiological features associated with the presence of jcv dna in the cerebrospinal fluid. jcv-associated cns diseases were classified as follows: 1) classic pml; 2) inflammatory pml; and 3) jc virus granule cell neuronopathy (gcn). results: we included 47 cases. jcv-associated cns diseases were classified as follows: 1) classic pml: 42 (89%); 2) inflammatory pml: three (6%); and 3) jc virus gcn: four (9%). nosocomial pneumonia (p = 0.003), previous diagnosis of hiv infection (p = 0.03), and imaging showing cerebellar and/or brainstem involvement (p = 0.02) were associated with in-hospital mortality. overall mortality during hospitalization was 34%. conclusions: novel presentations of jcv-associated cns diseases were observed in our setting; nosocomial pneumonia, previous diagnosis of hiv infection, and cerebellar and/or brainstem involvement were associated with in-hospital mortality; and overall mortality was high.
%K jc virus
%K leukoencephalopathy
%K progressive
%K multifocal
%K diagnosis
%K acquired immunodeficiency
%K syndrome
%K brazil.
%U http://www.scielo.br/scielo.php?script=sci_abstract&pid=S1413-86702012000200008&lng=en&nrm=iso&tlng=en