Convection-enhanced intraparenchymal delivery (CEID) of cytosine arabinoside (AraC) for the treatment of HIV-related progressive multifocal leukoencephalopathy (PML)

AIDS-related PML continues to be a relatively common and rapidly fatal infection in patients with AIDS, and no effective therapy has been established to alleviate the effects of this disease. Through the years, isolated reports and small case studies have shown somewhat encouraging results using cyt...

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Bibliographic Details
Published in:Journal of neurovirology 2001, Vol.7 (4), p.382-385
Main Author: M Levy, Eugene Major, Mir Jafer Ali, Bruce Cohen, Dennis Groothius, Robert
Format: Article
Language:English
Subjects:
AIDS-Related Opportunistic Infections - drug therapy
Animals
Antiviral Agents - pharmacology
araC protein
Cytarabine - pharmacokinetics
cytosine arabinoside
Drug Delivery Systems - methods
Human immunodeficiency virus
Humans
Leukoencephalopathy, Progressive Multifocal - drug therapy
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Summary:AIDS-related PML continues to be a relatively common and rapidly fatal infection in patients with AIDS, and no effective therapy has been established to alleviate the effects of this disease. Through the years, isolated reports and small case studies have shown somewhat encouraging results using cytosine arabinoside (AraC) in the treatment of PML. The optimism behind the use AraC for this disease began to fade with ACTG trial 243, which suggested that AraC had no benefit in patients with HIV-related PML. In this article, we provide evidence that suggests that the failure of AraC in the ACTG trial may have been due to insufficient delivery of the drug through traditional intravenous and intrathecal routes. Furthermore, we provide evidence that convection-enhanced intraparenchymal delivery of AraC may prove to be a safe and effective means of treating this infection, and we outline a clinical trial that we have recently undertaken to test this hypothesis. Journal of NeuroVirology (2001) 7, 382-385.
ISSN:1355-0284
1538-2443
DOI:10.1080/13550280152537283