HIV DRUG MAY HELP TREAT PML

It's too early to say whether maraviroc will become a standard part of PML treatment. On the other hand, for clinicians with PML patients on their hands, it seems likely that many if not most will give maraviroc a try -- given the risks of not trying.
A relatively simple way to make progressive multifocal leukoencephalopathy (PML) more survivable appears to have worked in a multiple sclerosis patient taking natalizumab (Tysabri).

It's too early to say whether maraviroc will become a standard part of PML treatment. On the other hand, for clinicians with PML patients on their hands, it seems likely that many if not most will give maraviroc a try -- given the risks of not trying.

With natalizumab-related PML, the death rate has been about 20%, and many patients who have survived show permanent neurocognitive deficits. Consequently, clinicians want to treat it aggressively. The normal treatment is plasmapheresis, in order to remove natalizumab (which has a long half-life) from circulation as quickly as possible, restoring immune function and suppression of the JC virus.

Unfortunately, the sudden removal of natalizumab often triggers a condition called immune reconstitution inflammatory syndrome (IRIS), which is practically as dangerous as PML. Many of the deaths and persistent deficits attributed to PML actually are a consequence of IRIS.

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