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Is PML reversable?

Nov 18, 2006

I received my HIV+ diagnosis back in 1990. Things were going well although my CD4 counts were slowly declining to the point at which we were debating whether or not to start the meds.

Three years ago I started having major problems with vertigo. The doctors I saw could not come up with any diagnosis.

Then I had an episode of numbness on one side of my face. Fearing a stroke, my family doctor sent me for an MRI. The diagnosis came back as PML. I happened to be in her office right after she received the fax from the lab. She gave me a copy and said she had not had time to learn much about it.

So I went back to work (it was a lunch-time appointment) and immediately got on the net. The very first article I found said that PML is usually fatal one to three months after diagnosis. Needless to say, I didn't stay in the office for the afternoon.

I was able to get into the HIV clinic three days later and started on meds immediately.

My second MRI, about six months later, showed that the PML was not as bad as it was on the first one.

I have not had another MRI and my specialist says we won't do another one unless I start experiencing neurological symptoms.

Have there been other cases of people "recovering" from PML? Most of the things I encounter on the web say that people "survive" for a few years longer, but nothing about getting better. Should I insist that I get periodic MRIs so I can track what might be going on?

Response from Dr. Holodniy

Yes, people with HIV infection and PML, can improve dramatically with HIV treatment. I don't think you need to get periodic MRIs unless there are new or worsening neurologic findings.

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