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pml questions
Oct 7, 2003

Could you explain PML to me? I know a person with it and the symptoms are coming pretty quickly. For instance we thought she had a stroke and it was affecting her left side. She was still walking and talking and in a matter of a couple of days, she can't walk, hardly talk or do anything for herself. A person like this with a T cell of 19, how long do you think they could live?

Response from Dr. Conway

PML is caused by a virus (JC virus or BK virus) of the same family as the viruses that cause warts. Most people are exposed to these viruses in childhood, but their immune systems keep them under control. It is only when the CD4 count drops below 50 or so that it can act up, causing a variety of neurological symptoms.

There is no specific treatment for this, EXCEPT that the initiation of HAART can lead to a significant rise in the CD4 cell count, and allow the body to handle the infection on its own. Therefore, if she can take anti-HIV meds and responds to them, she could live a long, long time.

In the meantime, it is very important that rehabilitation be started to make sure she doesn't lose too much ground while waiting for HAART to kick in. This must include a consultation with a speech therapist to make sure she doesn't lose the ability to speak.

Good Luck.



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