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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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h i v and pml
Apr 7, 2009

march 2007 i was veary sick whent to the hospital i was not abile to talk or walk doctor at columbia in n.y.c gave me blood test cat secan m.r i they said that i had h i v and p m l they did not think i would live the m r i showed brain lessions on the part of the brain that controled my speech and my movement they gave me antiviral in a iv all that day few days later they said i was goimg to make it my c d 4 was 211 two years later my c d 4 is 513 i can walk my voice is slowly coming back i have nerv damage but getting better i,m on kaletra-combivir for h i v and keppra and gabapentin for seizurs viral load is undetectabil i was in the nursing home for one year all of you doctors are great thank you what kind of treatmnt will help the p m l recovery

Response from Dr. Henry

There is no specific effective treatment for PML other than antiretroviral therapy for the underlying HIV infection and associated immune damage. Having PML (due to JC virus infection of the brain) is alot like having a stroke with high blood pressure. You can get the blood pressure under control (like getting the HIV under control) but the recovery from the stroke depends on which areas of the brain were damaged and how extensive the damage was. Controlling the blood pressure (of HIV) will possibly prevent further damage but does little to reverse structural damage. The course of stabilization and recovery is highly variable and the chances for a better recovery are often related to how low the CD4 count was (the lower often the worse the chances for good outcome-yours sounded decent) and again how extensive the structural damage was at the time of diagnosis. I have some patients still doing OK with PML now 13 years after their diagnosis as well as several patients doing poorly presenting recently with very low CD4 counts and extensive brain damage. KH

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