High-level polyomavirus JC viruria following long-term steroid therapy

Area of Science:

• Virology
• Immunology

Background:

• JC virus (JCV) is a common polyomavirus causing persistent, usually asymptomatic infections.
• JCV establishes latency in tissues like the brain and genitourinary tract.
• Unlike BK polyomavirus, JC viruria is nearly universal in healthy adults.

Observation:

• This study details a case of an immunocompetent patient.
• The patient presented with exceptionally high levels of asymptomatic JC viruria.
• This condition occurred after a prolonged course of steroid therapy.

Findings:

• Long-term steroid use can lead to high-level asymptomatic JC viruria even in immunocompetent individuals.
• This contrasts with the typical understanding of JCV shedding in healthy populations.
• The findings highlight a potential risk associated with immunosuppression.

Implications:

• This case underscores the importance of monitoring for opportunistic infections during prolonged immunosuppressive therapy.
• It suggests that steroid therapy can reactivate or increase shedding of latent viruses like JCV.
• Further research may be needed to understand the threshold of immunosuppression leading to significant JC viruria.