BK virus associated meningoencephalitis in an AIDS patient treated with HAART

José E Vidal¹^,5 , Maria C Fink⁶ , Filiberto Cedeno-Laurent¹⁰ , Serena Delbue⁸ , Pasquale Ferrante⁷^,8 , Rafi F Dauar³ , Francisco Bonasser Filho¹ , Roberta Schiavon Nogueira¹ , Eduardo E Calore⁴ , Claudio S Pannuti⁶ , J Roberto Trujillo¹⁰ and Augusto C Penalva de Oliveira²^,9

¹Department of Infectious Diseases, Emilio Ribas Institute of Infectious Diseases, São Paulo, Brazil

²Department of Neurology, Emilio Ribas Institute of Infectious Diseases, São Paulo, Brazil

³Department of Neurosurgery, Emilio Ribas Institute of Infectious Diseases, São Paulo, Brazil

⁴Department of Pathology, Emilio Ribas Institute of Infectious Diseases, São Paulo, Brazil

⁵Department of Infectious Diseases, São Paulo University, São Paulo, Brazil

⁶Laboratory of Virology of the Institute of Tropical Medicine, São Paulo University, Brazil

⁷Laboratory of Molecular Medicine and Biotechnology of Don C. Gnocchi Foundation ONLUS, IRCCS, Milan, Italy

⁸Department of Technology and Biomed Sciences University of Milan, Italy

⁹Clinical Research Unit on Human Retrovirology, University of Campinas, São Paulo, Brazil

¹⁰Institute of Human Virology, University of Maryland Biotechnology Institute, UMD, USA

author email corresponding author email

AIDS Research and Therapy 2007, 4:13doi:10.1186/1742-6405-4-13


Published:	8 June 2007

Abstract

A severely immune-suppressed AIDS patient was suspected of suffering from BK virus (BKV) meningoencephalitis, after being studied for common causes of neurological complications of co-infectious origin. Polymerase chain reaction (PCR) and sequence analysis of cerebrospinal fluid and brain samples, confirmed the presence of BKV. His clinical condition improved along with the regression of brain lesions, after modifications on his antiretroviral regime. Five months after discharge, the patient was readmitted because of frequent headaches, and a marked inflammatory reaction was evidenced by a new magnetic resonance imaging (MRI). The symptoms paralleled a rising CD4⁺lymphocyte count, and immune reconstitution syndrome was suspected. This is the first non-postmortem report of BKV meningoencephalitis in an AIDS patient, showing clinical and radiographic improvement solely under HAART.