BK virus associated meningoencephalitis in an AIDS patient treated with HAART

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.

José E. Vidal is supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) grant 001/0700/000186/2003. Pasquale Ferrante is supported by NIH grant MH068360-01. The authors thank to A.F. Tateno, M.C.A. Bernal, and J.E. Martins for their technical support. We are indebted to Drs. Walter Royal III and Anthony Amoroso, as well as to Elaine B Trujillo for helpful reviews of the manuscript.

José E. Vidal is supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) grant 001/0700/000186/2003. Pasquale Ferrante is supported by NIH grant MH06836001. The authors thank to A.F. Tateno, M.C.A. Bernal, and J.E. Martins for their technical support. We are indebted to Drs. Walter Royal III and Anthony Amoroso, as well as to Elaine B Trujillo for helpful reviews of the manuscript.