Overall Survival in People Living with HIV, Who Experienced Progressive Multifocal Leukoencephalopathy
Author(s)
Elizabeth Westerberg, PhD1, Claire L. Simons, PhD1, Craig Bennison, MSc2, Iain A. Kaan, MBA, DrPH3, Katharina Buesch, MSc4;
1OPEN Health Evidence and Access, Rotterdam, Netherlands, 2OPEN Health Evidence and Access, London, United Kingdom, 3Aeolian Logic Pte. Ltd, Singapore, Singapore, 4KJM Büsch Consulting GmbH, Consultant, Zug, Switzerland
1OPEN Health Evidence and Access, Rotterdam, Netherlands, 2OPEN Health Evidence and Access, London, United Kingdom, 3Aeolian Logic Pte. Ltd, Singapore, Singapore, 4KJM Büsch Consulting GmbH, Consultant, Zug, Switzerland
OBJECTIVES: Progressive multifocal leukoencephalopathy (PML) is a rare but fatal opportunistic infection caused by reactivation of latent JC polyomavirus (JCV). Restoring cellular immunity is key to controlling JCV, with antiretroviral therapy (ART) playing a crucial role in improving immune response and PML prognosis in people living with Human Immunodeficiency Virus [HIV](PLWH). This analysis aims to characterise the overall survival (OS) of PLWH diagnosed with PML.
METHODS: Individual-level data for PLWH diagnosed with PML were extracted from case studies identified through a systematic literature review. Kaplan-Meier methods were used to assess survival outcomes, including the duration from symptom onset to diagnosis and overall survival post-diagnosis. Statistical analyses also explored potential factors influencing survival, such as treatment type and timing of diagnosis.
RESULTS: In total, 65 PLWH diagnosed with PML were included in the analysis (23% female, 69% male, 8% sex not reported). Mean age at HIV diagnosis (n=35) was 38.06 years, at PML symptom onset (n=50) 40.85 years at PML diagnosis (n=65) 42.88 years and at last follow up (n=65) 43.96 years. In total, 31 individuals (48%) died with a mean age of 41.03 years. Median time (95%CI) from symptom onset to PML diagnosis was 1.2 months (0.72-2.04). Median time (95%CI) from diagnosis to death was 7.92 months (3-42). The majority of individuals were started on a regimen of either ART (antiretroviral therapy), cART (combined antiretroviral therapy), or HAART (highly active antiretroviral therapy). In total, 46 PLWH were treated for their PML (71%), while 19 individuals were not treated or no PML treatment information was reported (29%). Publication bias in source data was a possible limitation.
CONCLUSIONS: The reduced survival of individuals with HIV who experience PML indicates a high disease burden, unmet need for treatment and clinical management for PML.
METHODS: Individual-level data for PLWH diagnosed with PML were extracted from case studies identified through a systematic literature review. Kaplan-Meier methods were used to assess survival outcomes, including the duration from symptom onset to diagnosis and overall survival post-diagnosis. Statistical analyses also explored potential factors influencing survival, such as treatment type and timing of diagnosis.
RESULTS: In total, 65 PLWH diagnosed with PML were included in the analysis (23% female, 69% male, 8% sex not reported). Mean age at HIV diagnosis (n=35) was 38.06 years, at PML symptom onset (n=50) 40.85 years at PML diagnosis (n=65) 42.88 years and at last follow up (n=65) 43.96 years. In total, 31 individuals (48%) died with a mean age of 41.03 years. Median time (95%CI) from symptom onset to PML diagnosis was 1.2 months (0.72-2.04). Median time (95%CI) from diagnosis to death was 7.92 months (3-42). The majority of individuals were started on a regimen of either ART (antiretroviral therapy), cART (combined antiretroviral therapy), or HAART (highly active antiretroviral therapy). In total, 46 PLWH were treated for their PML (71%), while 19 individuals were not treated or no PML treatment information was reported (29%). Publication bias in source data was a possible limitation.
CONCLUSIONS: The reduced survival of individuals with HIV who experience PML indicates a high disease burden, unmet need for treatment and clinical management for PML.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH97
Topic
Epidemiology & Public Health
Disease
SDC: Infectious Disease (non-vaccine), SDC: Rare & Orphan Diseases