title: JC virus load in progressive multifocal leukoencephalopathy: analysis of the correlation between the viral burden in cerebrospinal fluid, patient survival, and the volume of neurological lesions.
abstract: JC virus (JCV) is the causative agent of progressive multifocal leukoencephalopathy (PML), a demyelinating central nervous system infection that mainly affects patients with acquired immunodeficiency syndrome. The diagnostic value of the detection of JCV DNA in cerebrospinal fluid (CSF) has been proved. A correlation between the JCV burden in CSF and the PML prognosis has been proposed. To our knowledge, the present study is the first to examine JCV burden in CSF in relation to the magnitude of neurological damage. An in-house quantitative polymerase chain reaction assay was used for measurement of the JCV burden in CSF samples from 12 patients with PML. A wide variation in JCV load (6.4 log) was found among the patient CSF samples, a finding that makes JCV load measurements worthwhile. Virus load values of >4.68 log were associated with shorter patient survival time. No correlation was found between the virus load values and the global volume of brain tissue damaged. Our data suggest that factors other than the volume of neurological lesions influence the shedding of JCV in the CSF.
authors.affiliation: Servicio de Microbiología y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain. dgviedma@microb.net
authors.forename: Darío
authors.initials: D
authors.lastname: García De Viedma
authors.forename: Marisol
authors.initials: M
authors.lastname: Díaz Infantes
authors.forename: Pilar
authors.initials: P
authors.lastname: Miralles
authors.forename: Juan
authors.initials: J
authors.lastname: Berenguer
authors.forename: Mercedes
authors.initials: M
authors.lastname: Marín
authors.forename: Lucía
authors.initials: L
authors.lastname: Muñoz
authors.forename: Emilio
authors.initials: E
authors.lastname: Bouza
mesh_terms: D000328:Adult; D002490:Central Nervous System / Q000473:pathology*; D004279:DNA, Viral / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D007577:JC Virus / Q000145:classification / Q000235:genetics / Q000502:physiology*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000401:mortality / Q000473:pathology / Q000821:virology*; D008297:Male; D009422:Nervous System Diseases / Q000473:pathology* / Q000821:virology; D016133:Polymerase Chain Reaction / Q000379:methods; D011786:Quality Control; D013223:Statistics as Topic; D016019:Survival Analysis; D019562:Viral Load
chemical_list: D004279:DNA, Viral