Progressive multifocal leukoencephalopathy triggered by COVID-19 in a previously asymptomatic person living with undiagnosed HIV infection

Yago Marcos Pessoa-Gonçalves; Thaís Soares Farnesi-de-Assunção; Marlos Aureliano Dias de Sousa; Luis Marcos Ferreira Junior; Beatriz Sodré Matos; Anna Victória Bernardes Borges; Ana Carolina de Morais Oliveira-Scussel; Alex Eduardo da Silva; Carlo José Freire Oliveira; Marcos Vinicius da Silva; Virmondes Rodrigues Junior

doi:10.1016/j.ijid.2023.09.020

Progressive multifocal leukoencephalopathy triggered by COVID-19 in a previously asymptomatic person living with undiagnosed HIV infection

Int J Infect Dis. 2023 Dec:137:1-3. doi: 10.1016/j.ijid.2023.09.020. Epub 2023 Oct 1.

Affiliations

¹ Institute of Natural and Biological Sciences, Department of Microbiology, Immunology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil.
² Institute of Health Sciences, Department of Neurology, Federal University of Triângulo Mineiro, Uberaba, Brazil.
³ Institute of Natural and Biological Sciences, Department of Microbiology, Immunology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil. Electronic address: [email protected].

PMID: 37788739
DOI: 10.1016/j.ijid.2023.09.020

Abstract

This report presents the case of a 47-year-old male patient who worked as a mathematics teacher and experienced the sudden onset of disorientation, aphasia, and acalculia during an online class. The current study reveals the first documented case of HIV and progressive multifocal leukoencephalopathy with the detection of SARS-CoV-2 and human polyomavirus 2 (previously known as John Cunningham virus) in the cerebrospinal fluid. Furthermore, serum analysis revealed elevated concentrations of interleukin (IL)-6, IL-17, and IL-8, which are potential factors known to reduce the expression of tight junctions and adhesion molecules in the extracellular matrix, thereby affecting the permeability of the blood-brain barrier. Finally, the study discusses whether SARS-CoV-2 triggers or exacerbates progressive multifocal leukoencephalopathy.

Keywords: HIV; Human polyomavirus 2; John Cunningham Virus; Pro-inflammatory cytokines; Progressive multifocal leukoencephalopathy; SARS-CoV-2.

Publication types

Case Reports

MeSH terms

COVID-19* / diagnosis
HIV Infections* / complications
Humans
JC Virus*
Leukoencephalopathy, Progressive Multifocal* / diagnosis
Magnetic Resonance Imaging
Male
Middle Aged
SARS-CoV-2