title: Anti-JCV antibodies detection and JCV DNA levels in PBMC, serum and urine in a cohort of Spanish Multiple Sclerosis patients treated with natalizumab.
abstract: One of the most effective multiple sclerosis (MS) treatment is natalizumab. Nevertheless, it has been associated with an increased risk of progressive multifocal leukoencephalopathy (PML) caused by the JC virus (JCV). Our main objective was to assess the utility of testing JCV-DNA, apart from anti-JCV antibodies, to determine which natalizumab-treated MS patients has been previously in contact with the virus. For this purpose, 138 MS natalizumab/non-natalizumab treated patients participated in several studies. Cross-sectional study (CS): association of several epidemiological variables with anti-JCV antibodies and JCV-DNA levels in PBMC/serum/urine. First longitudinal study (A): evaluation of JCV-DNA prevalence in urine throughout the treatment. Second longitudinal study (B): simultaneous assessment of antibodies and viral DNA levels in PBMC/serum/urine at two time points. CS: The seropositivity rate for anti-JCV antibodies (62.3 %) and JCV prevalence in urine (59.4 %) were similar; although 26 % of our population was positive only using one of the two techniques. A: The viral prevalence in urine seemed to increase between the baseline visit and the others (Baseline-Visit/V18months, p = 0.006). B: Our rate of positive antibody seroconversion was 36 %. Nearly all patients with detectable JCV-DNA levels in PBMC excreted the virus intermittently in urine; while our PML case, positive in PBMC and serum samples 2 month before the PML, excreted JCV permanently. In conclusion, the determination of JCV DNA levels in urine could be complementary to anti-JCV antibodies for identifying MS patients who has been infected by the JCV. Further research would be necessary to understand the different JCV excretion profiles in urine.
authors: Unidad de Esclerosis Múltiple, Hospital Clínico San Carlos. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040, Madrid, Spain, idominguez.hcsc@salud.madrid.org.
authors: Maria Inmaculada
authors: MI
authors: Dominguez-Mozo
authors: Marta
authors: M
authors: Garcia-Montojo
authors: Virginia
authors: V
authors: De Las Heras
authors: Angel
authors: A
authors: Garcia-Martinez
authors: Ana María
authors: AM
authors: Arias-Leal
authors: Ignacio
authors: I
authors: Casanova
authors: Rafael
authors: R
authors: Arroyo
authors: Roberto
authors: R
authors: Alvarez-Lafuente
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000914:Antibodies, Viral / Q000032:analysis*; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000032:analysis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007577:JC Virus; D007963:Leukocytes, Mononuclear / Q000821:virology; D007968:Leukoencephalopathy, Progressive Multifocal / Q000517:prevention & control; D008297:Male; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000821:virology*; D000069442:Natalizumab; D027601:Polyomavirus Infections / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000914:Antibodies, Viral; D004279:DNA, Viral; D000069442:Natalizumab
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