Table 5.
Patient Characteristics for Individuals with Progressive Multifocal Leukoencephalopathy-Related Immune Reconstitution Inflammatory Syndrome (N = 11)
| Patient | Gender | Date CSF JCV | IRIS type | ART at diagnosis | Prior CD4 (date) | CD4 at diagnosis (date) | CD4 at IRIS (date) | Treatment regimen | Steroid duration in days and start date | Outcome and outcome date |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | F | November 19, 2012 | Paradoxical | 3TC, AZT, RAL, DRV/r | 57 (June 21, 2012) | 145 (November 15, 2012) | 136 (December 13, 2012) | None | N/A | Hospice (August 8, 2013) |
| 2 | M | March 13, 2014 | Unmasking | TDF, FTC, EFVa | N/A | 70 (March 13, 2014) | N/A | Dexamethasone 32 mg | 7 (March 14, 2014) | Hospice (March 20, 2014) |
| 3 | M | April 23, 2014 | Paradoxical | TDF, FTC, ABC, ATV/r | 13 (January 22, 2014) | 8 (March 26, 14) | 40 (May 30, 2014) | Dexamethasone 12 mg | 14 (June 7, 2014) | Hospice (June 20, 2014) |
| 4 | M | April 22, 2014 | Paradoxical | TDF, FTC, DRV/r | 12 (July 30, 2013) | 19 (April 22, 2015) | 29 (November 7, 2015) | Methylprednisolone 1 gm Prednisone 60 mg (taper) |
28 (September 26, 2015) | Hospice (November 16, 2015) |
| 5 | M | August 26, 2015 | Paradoxical | ABC, 3TC, DTG | N/A | 89 (August 20, 2015) | 162 (September 19, 2015) | None | N/A | Survived |
| 6 | M | September 11, 2015 | Paradoxical | TDF, FTC, ELV/c | N/A | 37 (September 11, 2015) | 117 (October 20, 2015) | Dexamethasone 32 mg | 4 (November 2, 2015) | Hospice (November 5, 2015) |
| 7 | M | December 14, 2015 | Paradoxical | TDF, FTC, ELV/c | N/A | 63 (December 12, 2015) | 78 (January 24, 2016) | Methylprednisolone 1 gm Maraviroc |
6 (January 27, 2016) | Death (February 8, 2016) |
| 8 | M | April 13, 2016 | Paradoxical | TDF, FTC, DTG, DRV/c | 52 (October 7, 2015) | 10 (March 17, 2016) | 57 (June 1, 2016) | Methylprednisolone 1 gm Dexamethasone 10 mg (taper) |
35 (June 23, 2016) | Death (July 27, 2016) |
| 9 | F | September 20, 2016 | Unmasking | ABC, 3TC, DTGa | 49 (September 1, 2016) | 164 (September 21, 2016) | 191 (October 24, 2016) | Prednisone 60 mg (taper) Maraviroc |
36 (September 21, 2016) | Survived |
| 10 | M | December 9, 2016 | Paradoxical | TDF, FTC, DRV/ra | N/A | 53 (December 6, 2016) | N/A | Methylprednisolone 1 gm Prednisone 60 mg (taper) |
26 (December 17, 2016) | Death (January 26, 2017) |
| 11 | M | December 19, 2016 | Paradoxical | TDF, FTC, DTG, MVCb | N/A | 46 (December 18, 2016) | 131 (February 6, 2017) | Methylprednisolone 1 gm | 2 (February 8, 2017) | Hospice (February 10, 2017) |
a
Reported good adherence to ART before PML diagnosis, remainder had poor/no adherence to ART before PML diagnosis.
b
MVC started before PML-IRIS diagnosis explicitly to prevent IRIS.
3TC, lamivudine; ABC, abacavir; ATV, atazanavir; AZT, zidovudine; c, cobicistat; DRV, darunavir; DTG, dolutegravir; EFV, efavirenz; ELV, elvitegravir; FTC, emtricitabine; MVC, maraviroc; N/A, not applicable; r, ritonavir; RAL, raltegravir; TDF, tenofovir.