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To the Editor:
In a comparative clinical study of the main HIV-related focal brain lesion (FBL)–causing disorders, Ammassari et al.,1 in the highly active antiretroviral therapy (HAART) period, reported a strong decline of AIDS-related primary CNS lymphomas (PCNSL), with stable toxoplasmotic encephalitis and a slight increase in progressive multifocal leukoencephalopathy (PML). These data are at variance with personal findings in an autopsy series of 450 consecutive AIDS cases in Vienna, Austria, between 1984 and 1999 (397 men, 53 women, mean age at death 83.4 years), where the introduction of HAART caused considerable changes in CNS pathology. In particular, there was a significant decrease in the incidence of toxoplasmic encephalitis (8% in the HAART era as compared to 20 to 24% in previous periods), whereas the incidence of both PML (around 5 to 6% in both periods) and of PCNSL (around 6%) remained stable during the last 15 …
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