Abstract—Progressive Multifocal Leukoencephalopathy (PML) is seen mostly in advanced human immunodeficiency virus (HIV) infection. In some individuals, especially those with very low CD4+ counts, worsening of PML or new-onset PML can be observed after the initiation of highly active antiretroviral therapy (HAART). A case of IRIS associated PML is reported here which is much more rare as compared to PML in HIV patients unrelated to HAART. This is thought to be secondary to immune reconstitution inflammatory syndrome (IRIS). IRIS is defined as a paradoxical deterioration of a previously existing infection which is related to the immune system recovery. It is suggested to occur due to an imbalance of CD8+/CD4+ T cells. So in HIV cases with low CD4 counts and if one is on HAART then should be further investigated for IRIS and PML.
Keywords: PML, HIV, HAART, IRIS
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