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Viral Load Undetected No Change in PML

Jan 14, 2000

Someone is diagnosed with PML due to Aides. Ater 2 months of treatment Viral load is now undetectable, Tcell count is climbing slowly (60), why is there no signs of improvement with the PML? Are we expecting it too soon?

Response from Dr. Currier

We believe PML is probably caused by another viral infection caused by the JC virus. There have been anecdotal case reports published that suggest HAART therapy alone can result in the improvement or disappearance of PML. This is probably related to improvement in immune function and increase in CD4 cells, rather than a direct effect against this other virus. A CD4 count of 60 is still very low and may not be high enough to see this kind of improvement. Alternatively, PML can be treated with cidofovir (used for CMV retinitis), which has activity against the JC virus and administration has also resulted in clinical improvement. MH

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