Human Polyomavirus-Associated Cerebral Disorders in the Post-HAART Era
Figure 1
(a) Left, image shows classical PML, described as multiple foci of demyelination in the subcortical white matter. Right, image shows variant PML, described as one or multiple foci in regions outside the subcortical white matter, for example, the cerebellar peduncles (arrows). (b) Course and evolution of an AIDS patient with PML under HAART. From left to right, first column shows MRI with abnormal signal in the subcortical area of bilateral frontal lobes; diagnosis is confirmed by histopathology and treatment with HAART is started. The second column shows significant improvement under HAART. The third column shows worsening of the lesions three months after introduction of HAART (immune reconstitution syndrome). The fourth column shows improvement of the lesions after empiric treatment with intravenous immunoglobulin (IVIG).
