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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
          
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PML
Apr 2, 2006

Dr Henry, in my search for information on this site, you seem to respond to most concerning PML. I was diagnoded with pml about 1 year ago. Complications progressed rapidly at first but have slowed with drugs that have gotten my VL to undetectable levels. Since last July my only new problems would be some difficulties talking. I often get tongue tied and must drink water or break between words. I experience an almost constant feeling that I have something in the back of my throat. At times it feels fuzzyy and at times it feels like hair. I do not have thrush and a barium swallow exam showed nothing. Do yo think this may just be neurological problems due to the PML? Also, why is there so little new information available about PML? There are no new studies and most articles date back several years. Thanks for your time.

Response from Dr. Henry

The symptoms you describe certainly could be due to residual brain effects of PML. PML in the setting of AIDS used to be uniformly fatal but since the advent of potent HIV therapy the situation has improved markedly. I have several 10+ survivors of PML who continue to do well though they have persisten chronic neurologic deficit from their original PML-related brain damage. PML is not seen nearly as often in the setting of AIDS in the US so the incentive to focus on studying new treatments has decreased (progress is slow when there are few cases to enroll in studies). Sorry I can't be more current but you have correctly noted that new progess has slowed with more of the emphasis on preventing PML by identifying HIV+ persons early and starting HIV meds before a patient is at risk for PML (usually with a very low CD4 count). KH



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