Reduced rate of diagnostic positive detection of JC virus DNA in cerebrospinal fluid in cases of suspected progressive multifocal leukoencephalopathy in the era of potent antiretroviral therapy.
Fifty-nine human immunodeficiency virus (HIV)-infected patients with suspected progressive multifocal leukoencephalopathy and 224 controls were tested for JC virus (JCV) DNA in cerebrospinal fluid by PCR. The diagnostic positive detection rate dropped from 89.5% (95% confidence intervals of 75.5 to 103.5%) in the pre-highly active antiretroviral therapy (HAART) era to 57.5% (95% confidence intervals of 42.1 to 72.9%) in the HAART era; the specificity remained unchanged. Predictors of failure to detect JCV DNA were exposure to HAART at disease onset and higher CD4 counts.
Marzocchetti
Angela
A
Istituto di Clinica delle Malattie Infettive, Università Cattolica del Sacro Cuore, Largo Gemelli, 8, 00168 Rome, Italy. angela.marzocchetti@tin.it
Di Giambenedetto
Simona
S
Cingolani
Antonella
A
Ammassari
Adriana
A
Cauda
Roberto
R
De Luca
Andrea
A
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D004279:DNA, Viral / Q000134:cerebrospinal fluid*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D006801:Humans; D007577:JC Virus / Q000302:isolation & purification*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000175:diagnosis / Q000821:virology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction
D019380:Anti-HIV Agents; D004279:DNA, Viral