Journal of Multiple Sclerosis

Progressive Multifocal Leukoencephalopathy in Africa–A Review

Clara-M Schutte

Progressive multifocal leukoencephalopathy caused by the JC virus, results in a lytic infection of mainly oligodendrocytes of the central nervous system in immunosuppressed patients. With the advent of the HIV pandemic, the incidence of PML has risen sharply, but very few cases from Africa have been reported, even though this continent carries a very high burden of HIV infection. Explanations for the paucity of reports of PML from Africa include non-recognition of the condition, diagnostic challenges, death due to other infections, as well as suggestions of decreased neurovirulence of African JC virus types, and interactions between these types and different HIV clades. In this report we focus on reports of cases with PML from Africa, suggesting that with the availability of more sensitive assays and greater awareness, the diagnosis of PML may be more readily made in the future.