Progressive Multifocal Leukoencephalopathy, HIV, and Highly Active Antiretroviral Therapy

Abstract
The results of AIDS Clinical Trials Group Study 243, reported by Hall et al. (May 7 issue),1 show that neither cytarabine nor regimens of one or two reverse-transcriptase inhibitors affect the course of progressive multifocal leukoencephalopathy in patients infected with the human immunodeficiency virus (HIV). Recent case reports have indicated that neurologic conditions and survival may improve in patients with progressive multifocal leukoencephalopathy who receive highly active antiretroviral therapy, including protease inhibitors.2-4 Protease inhibitors became widely available only after the cytarabine trial.1