Hello Dr Pierone, I am currently caring for my brother who has been diagnosed with PML. Since he has virtually no income he is relying on treatment from a Dr that works with patients at a local Aids Clinic, free of charge. I want to make sure my brother is getting the most current regimne of meds. The Dr claims that he consulted with Dr's at Stanford and in Detroit to get the best possible regiment for him. He is currently taking Videx EC 250mg, Emtriva 200mg, Viread 300mg & Sustiva 600mg. 1 a day each. He has been on this regimne for 3 weeks now and seems to be spiralling downhill very quickly. I want to make sure we are doing everything poosible to save his life. Is this regiment of meds a popular regimne for aids patients with PML? Are there newer more effective drugs he could use? Please help me to know if everything that should be being done is being done. Thank You, Kathy

Some patients with PML stabilize and improve with antiretroviral therapy alone. The regimen that your brother is on is aggressive and very good. One other approach that may help is to see if the doctor would consider treating him with Vistide. This is an intravenous medication for CMV disease that has some data showing potential for PML. I have treated several patients in desperate straits with PML with this agent in addition to antiretroviral medication and they made remarkable recoveries. There is not definitive proof that it works, but I would look into it. Good luck!