For a well written article on PML in general click on:
SF AIDS Fdn: BETA 9/97 -- Progressive Multifocal Leukoencephalopathy
Another article with a bit more scientific detail:
PML in Patients with HIV Infection
For more information on AIDS treatment in general visit the BETA website:
SF AIDS Fdn: Bulletin of Experimental Treatments for AIDS
This is where I got the first article.
James has had PML (presumably - he hasn't had a brain biopsy) since
early May of 1998. He lost his speech at first. It
was so quick and dramatic we thought it was a stroke at first.
For the next few months he would alternate between getting
worse to holding his own. He got bad enough he was put on Hospice
(he was until early 1999) and it really looked like he wouldn't last much
longer. We decided that there was no point in keeping him on his
AIDS medicines (Nelfinivir, Stavudine, &
Lamivudine). He was really bad, not in his right mind, acting
like a small child, trying to excape from the yard, falling like 10
times a day, couldn't swallow well, going through about a dozen diapers
a day. Then, within the space of two days he
improved dramatically.
His former doctor and nurses warned that the improvement probably wouldn't last long, but this was, but that was more than a year ago, and since then he has at least been slowly improving. I had him put back on his AIDS drugs, and also antidepressants (he looked depressed). He acts like an intelligent adult human again, but still can't talk or write. Diapers are a thing of the past. But the improvement is slow. He is still struggling, doing a little more each week.
James has never taken any specific treatment for PML. Early on
I asked him if he wanted to try any experimental treatments,
and he said no. I would have if I had been in his place, but
we are very different people. Like I said, he has never had a brain
biopsy (the neurosurgeons wouldn't do one) or any other test specific
for PML, just a series of MRIs and the process of
elimination ( they thought it was toxoplasmosis at first). I
credit his longevity and his improvement to pure stubbornness. He
was just here "talking" about this letter (he can usually do yes and
no pretty well, and I have gotten good at questioning him),
and agreed with that statement, but probably also credits God/Jesus,
something like that. He is very religious (I am not). But faith
can be a powerful thing I guess.
James' T cell counts have been going up from somewhere around 150 when
this started to somewhere in the mid 200's last time
I updated this page. His viral load bounced from some unknown
number at first (someone didn't do the test the first time around), to
undetectable (>500/ml), to 13,000-ish when he was off his medications,
to undetectable (>50/ml) last I updated this page (9/4/99). He wasn't
on any medications at all when this started. He had known that he
was HIV positive for a couple/three years, but had not been sick, and had
only started going to see the doctors at the VA hospital about a week before
this all started. He is one of those people who hates doctors and
pills.