Maraviroc and JC Virus-Associated Immune Reconstitution Inflammatory Syndrome

The immune reconstitution inflammatory syndrome can be a serious complication of immune reversal in the treatment of progressive multifocal leukoencephalopathy. A new potential treatment for IRIS is described in this letter.To the Editor: The immune reconstitution inflammatory syndrome (IRIS) can be a serious complication in immunocompromised patients in whom progressive multifocal leukoencephalopathy (PML) has developed. IRIS occurs in such patients when their immunocompromised state reverses.(1) Although restored immune surveillance is vital for clearing the JC virus that causes PML, improved management strategies for IRIS are needed because of its potential for considerable complications and death. The common, though unproven, use of glucocorticoids to treat IRIS may limit JC viral clearance.(2) Because of the indirect implication of chemokine receptor 5-positive (CCR5+) T cells in IRIS pathophysiology,(3) we used the small-molecule CCR5 ...