Antiviral Therapy for Progressive Multifocal Leukoencephalopathy

Abstract

Progressive Multifocal Leukoencephalopathy (PML) is a demyelinating disease of the brain caused by JC polyomavirus (JCV). PML occurs mostly in people with compromised immune systems like HIV infected persons, patients receiving treatment with immunomodulating monoclonal antibodies like MS patients treated with natalizumab, transplant recipients and patients suffering from hematological malignancies. To date there is no treatment with proven effectiveness for PML. Many different drugs have been tested, however, and in this review we summarize which drugs have been used and to what effect. From all drugs tested CMX001, mirtazapine and risperdone appear to be most promising. These drugs cross the blood brain barrier (BBB), are well tolerated and show promising results in case reports. Because these drugs haven’t been tested in controlled clinical trials further research is needed.