Journal of NeuroVirology, 9(suppl. 1): 47–53, 2003 c  2003 Taylor & Francis ISSN 1355-0284/03 $12.00+.00 DOI: 10.1080/13550280390195388 Clinical epidemiology and survival of progressive multifocal leukoencephalopathy in the era of highly active antiretroviral therapy: Data from the Italian Registry Investigative Neuro AIDS (IRINA) Andrea Antinori, 1 Antonella Cingolani, 2 Patrizia Lorenzini, 1 Maria Letizia Giancola, 1 Ilaria Uccella, 1 Simona Bossolasco, 3 Susanna Grisetti, 1 Francesca Moretti, 4 Beniamino Vigo, 5 Marco Bongiovanni, 6 Bruno Del Grosso, 1 Maria Irene Arcidiacono, 7 Giovanni Carlo Fibbia, 8 Maurizio Mena, 9 Maria Grazia Finazzi, 10 Giovanni Guaraldi, 11 Adriana Ammassari, 2 Antonella d’Arminio Monforte, 5 Paola Cinque, 3 and Andrea De Luca, 2 for the Italian Registry Investigative Neuro AIDS (IRINA) Study Group 1 Istituto Nazionale per le Malattie Infettive “Lazzaro Spallanzani,” IRCCS, Roma, Italy; 2 Clinica Malattie Infettive, Universit ` a Cattolica S. Cuore, Roma, Italy; 3 Divisione Malattie Infettive, Ospedale San Raffaele, IRCCS, Milano, Italy; 4 Clinica Malattie Infettive, Spedali Riuniti, Brescia, Italy; 5 Ospedale Niguarda, Milano, Italy; 6 Clinica Malattie Infettive e Tropicali, Ospedale Luigi Sacco, Milano, Italy; 7 ASL U.O. Ospedale Maggiore, Sant’Angelo Lodigiano, Lodi, Italy; 8 Divisione Malattie Infettive Ospedale “Carlo Poma,” Italy; 9 Ospedale Civile Milano, Cuggiono, Legnano, Italy; 10 Ospedali Riuniti, Bergamo, Italy; and 11 Universit ` a di Modena, Modena, Italy Human immunodeficiency virus (HIV)-associated progressive multifocal leukoencephalopathy (PML) remains a relevant clinical problem even in the era of highly active antiretroviral therapy (HAART). Aims of the study were to analyze clinical and treatment-related features and the survival probabil- ity of PML patients observed within the Italian Registry Investigative Neuro AIDS (IRINA) during a 29-month period of HAART. Intravenous drug use, the presence of focal signs, and the involvement of white matter at neuroradiol- ogy increased the risk of having PML. A reduced probability of PML was ob- served when meningeal signs were reported. Patients starting HAART at PML Address correspondence to Dr. Andrea Antinori, Clinical Department, National Institute for Infectious Diseases, “Lazzaro Spallanzani,” IRCCS, via Portuense 292, 00149 Roma, Italy. E-mail: antinori@inmi.it This work was supported by Programma Nazionale di Ricerca sull’AIDS, Istituto Superiore di Sanit` a, and by Ricerca Corrente e Finalizzata degli IRCCS, Ministero della Salute, Italy. IRINA, Scientific Committee: A Antinori (Study Coordinator), CF Perno, G Ippolito (National Institute for Infectious Diseases, Lazzaro Spallanzani, IRCCS, Roma, Italy), P Cinque (Department of Infectious Diseases, San Raffaele Hospital, IRCCS, Milano, Italy), A Cingolani, A De Luca, A Ammassari (Department of Infectious Diseases, Catholic University, Roma, Italy), A d’Arminio Monforte, C Balotta (Department of Infectious Diseases, L. Sacco Hospital, Milano, Italy), P Pezzotti, G Rezza (Centro Operativo AIDS, National Institute of Health, Roma, Italy). Coordinating center, database management and statistics: P Lorenzini, F Soldani, ML Giancola, I Uccella (Clinical Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Roma, Italy). Centers participating in the IRINA study: Az. Osp. Umberto I—Ancona (F Burzacchini); Osp. S. M. Ann.—Antella (FI) (L Mecocci); Osp. S. M. sopra i ponti—Arezzo (P Giorni); Pol. Univ. Bari (L Monno); Osp. Riun.—Bergamo (MG Finazzi); Sp. Civili—Univ. Brescia (F Moretti); Osp. Magg—Bologna (G Fasulo); Osp. Gen. Reg. Bolzano (O Moling); Osp. M. Bufalini—Cesena (S Brighi); Osp. Civ. Legnano— Pres. Osp. Cuggiono (MI) (M Mena); Az. Osp.—Univ. Ferrara (L Sighinolfi); Osp. Careggi—Firenze (P Corsi); Osp. S. Giov. Dio—Fondi (LT) (MT Di Toro); Osp. G. B. Morgagni—Forl` ı (A Mastroianni); Osp. S. C. Ges ` u—Gallipoli (LE) (M De Simone); Osp. S. Martino—Genova (G Mazzarello); Osp. Grosseto (T Carli); Osp. Felettino—La Spezia (S Artioli); Osp. S. M. Goretti—Latina (A Vetica); Osp. V. Fazi—Lecce (P Congedo); Osp. Maggiore—Lodi (MI Arcidiacono); Osp. C. Poma—Mantova (GC Fibbia); Osp. SS. Giacomo e Crist.—Massa Carrara (P Zannoni); Osp. L. Sacco—Univ. Milano (M Bongiovanni); IRCCS—Osp. S. Raffaele—Milano (S Bossolasco); Osp. Niguarda—Milano (B Vigo); Osp. Univ. Modena (G Guaraldi); Osp. S. Gerardo—Monza (S Foresti); Osp. Cotugno—Napoli (M Figoni); P. O. Casa del Sole— Palermo (ER Dallenogare); Osp. Guadagna—Palermo (G Rotondo); Osp. Civ.—Pescara (A Agostinone); Univ. Perugia (A Mariano); Osp. Civ. Piacenza (A Donisi); Osp. Pistoia (A Vivarelli); I, II, III, IV Div.–INMI–L Spallanzani IRCCS—Roma (L Loiacono, B Gigli, S Grisetti, B Del Grosso); Univ. Cattolica–Pol. A. Gemelli—Roma (D Larussa); Pol. Umberto I—Roma (M Ciardi); Osp. Rovigo (F Viviani); Osp. S. Paolo—Savona (M Palumbo); Osp. SS. Annunziata—Taranto (L Cristiano); Osp. E. S. Macchi—Varese (F Speranza). Received 13 October 2002; accepted 13 October 2002.