Dr Young, many times you have given me good advice. My vl remains undetectable and my cd4 is now 151 from 9. I have been on treatment for 12 months 8 months of those have been diagnosed with suspected pml, can manage all things except slight tremer in right arm cannot write etc but can do everything else and things seem to be improving every month. My doctor has suggested starting il-2 to boost my cd4 count above 200 and be monitered by professionals at the unit in the Uk that i go to. I am very much for the treatment but would welcome your professional advice first hand. Many thanks for your time.

Thanks for your comments. It is nice to know that our work reaches countries other than the US.

First of all, congratulations on an adherence job clearly well done-- your undetectable viral load speaks to this; as does the increase in CD4 cell count.

I have mixed opinions on IL-2. There is data that suggests that the use of the medication, with an undetectable viral load, can raise CD4 cell counts. What is not clear is what the functional meaning of these stimulated counts is; that is to ask, do these increases translate to improved survival or quality of life. There is certainly a concern that the medication can stimulate HIV replication if one is not adherent to treatment, possibly at some risk of drug resistance (as has been seen in a couple of my patients).

IL-2 is an injectable medication, with occasionally severe side effects (though self-limited).

In my practice, I have not used the medication with frequency, preferring to wait for HAART to do it's thing-- I would profer that this is already happening with your immune system, as manifest by increases in CD4 cells.

Either way, best advice is to continue to work hard on maintaining adherence, and certainly, keep asking plenty of questions. Good luck, BY