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Prevalence of JC virus viraemia in HIV-infected patients with or without neurological disorders: a prospective study
Abstract:
Progressive Multifocal Leukoencephalopathy (PML) is a severe demyelinating disease, which is rapidly fatal and is due to JC virus (JCV) infection, which especially occurs in HIV-infected patients. To investigate JCV pathophysiology and to evaluate the predictive value of JCV detection in blood, we looked for JCV DNA in leukocytes and plasma of 96 patients without any neurological symptoms and 109 patients with neurological diseases, among whom 19 were suffering from PML. JCV genome was detected in about 18% of all patients, i.e. 15.6% of patients with central nervous system disorders except PML, 13.5% of patients without neurological symptoms and significantly more often in PML patients (47.6%). Both leukocytes and plasma were tested; in plasma, JCV DNA was found in 36.1% of positive patients and in cells in 80.5%. Surprisingly in seven instances only the plasma contained JCV genome. One-year follow-up of these patients showed that the absence of JCV DNA in blood was associated with a very low probability of developing PML (negative predictive value=0.99).
Insights
JC virus (JCV) DNA detection in blood shows high predictive value for Progressive Multifocal Leukoencephalopathy (PML). Absence of JCV DNA in blood indicates a very low probability of developing this severe neurological disease.
Area of Science:
- Neurovirology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Progressive Multifocal Leukoencephalopathy (PML) is a fatal demyelinating disease caused by JC virus (JCV) infection, particularly in immunocompromised individuals like those with HIV.
- Understanding JCV pathophysiology and improving early detection are crucial for managing PML risk.
Purpose of the Study:
- To investigate the pathophysiology of JCV.
- To evaluate the predictive value of detecting JCV DNA in blood for the development of PML.
Main Methods:
- JCV DNA was detected in leukocytes and plasma from 96 asymptomatic individuals and 109 patients with neurological diseases, including 19 with PML.
- Quantitative PCR was used to detect JCV DNA in both blood cells and plasma.
Main Results:
- JCV DNA was detected in approximately 18% of all patients studied.
- Detection rates were significantly higher in PML patients (47.6%) compared to non-PML patients (15.6%) and asymptomatic individuals (13.5%).
- JCV DNA was found more frequently in leukocytes (80.5%) than in plasma (36.1%), but plasma-only detection occurred in seven cases.
Conclusions:
- The absence of JCV DNA in blood demonstrated a high negative predictive value (0.99) for developing PML within a one-year follow-up period.
- JCV detection in blood, particularly in plasma, holds significant potential for predicting PML risk, even in the absence of neurological symptoms.