title: JC virus urinary excretion and seroprevalence in natalizumab-treated multiple sclerosis patients.
abstract: The risk of developing progressive multifocal leukoencephalopathy (PML), as a consequence of infection/reactivation with JC virus (JCV), is consistent in natalizumab-treated multiple sclerosis (MS) patients, with 430 cases of PML reported so far. The risk of PML is higher in JCV seropositive patients, and it is recommended that only MS patients without JCV antibodies should be enrolled in the treatment postulating that they do not have JCV infection.We have studied forty-two natalizumab-treated MS patients, and urine and blood were collected monthly for up to 60 months. JCV and BK virus (BKV) DNA presence was verified using quantitative real-time PCR assays, and serum anti-JCV antibodies were measured with the Stratify and/or Stratify DxSelect tests.JCV and BKV DNA were not found in the blood samples, whereas they were found at least once in the urine of 21 of 42 (50 %) and of 25/42 (59.5 %) patients, respectively. JCV DNA urinary shedding increased up to month 24 of natalizumab treatment (45.2 %), and the effect of time was significant for JCV (p = 0.04), but not for BKV (p = 0.39). JCV viruria and seropositivity did not completely correlate, since three patients shedding JCV DNA in the urine were seronegative according to the serological tests.The results indicated that natalizumab therapy may increase the rate of JCV urinary shedding. Additionally, we confirmed that the identification of JCV carriers cannot solely rely on serological tests, but sensitive methods for viral DNA detection should be adopted to more precisely identify the truly JCV uninfected cases.
authors: Department of Biomedical Surgical and Dental Sciences, University of Milano, Via Pascal, 36, Milan, 20133, Italy.
authors: Serena
authors: S
authors: Delbue
authors: Laboratory of Translational Research Fondazione Ettore Sansavini, Lugo, Italy.
authors: Francesca
authors: F
authors: Elia
authors: Department of Biomedical Surgical and Dental Sciences, University of Milano, Via Pascal, 36, Milan, 20133, Italy.
authors: Camilla
authors: C
authors: Carloni
authors: Department of Biomedical Surgical and Dental Sciences, University of Milano, Via Pascal, 36, Milan, 20133, Italy.
authors: Valentina
authors: V
authors: Pecchenini
authors: Department of General Neurology, National Neurological Institute C. Mondino, Pavia, Italy.
authors: Diego
authors: D
authors: Franciotta
authors: Department of General Neurology, National Neurological Institute C. Mondino, Pavia, Italy.
authors: Matteo
authors: M
authors: Gastaldi
authors: Department of General Neurology, National Neurological Institute C. Mondino, Pavia, Italy.
authors: Elena
authors: E
authors: Colombo
authors: Department of Biomedical Surgical and Dental Sciences, University of Milano, Via Pascal, 36, Milan, 20133, Italy.
authors: Lucia
authors: L
authors: Signorini
authors: Department of Biomedical Surgical and Dental Sciences, University of Milano, Via Pascal, 36, Milan, 20133, Italy.
authors: Silvia
authors: S
authors: Carluccio
authors: Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
authors: Anna
authors: A
authors: Bellizzi
authors: Department of General Neurology, National Neurological Institute C. Mondino, Pavia, Italy.
authors: Roberto
authors: R
authors: Bergamaschi
authors: Department of Biomedical Surgical and Dental Sciences, University of Milano, Via Pascal, 36, Milan, 20133, Italy. pasquale.ferrante@unimi.it.|Istituto Clinico Città Studi, Milan, Italy. pasquale.ferrante@unimi.it.
authors: Pasquale
authors: P
authors: Ferrante
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood / Q000652:urine*; D004279:DNA, Viral / Q000097:blood / Q000652:urine*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007577:JC Virus / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000821:virology*; D000069442:Natalizumab / Q000627:therapeutic use*; D027601:Polyomavirus Infections / Q000821:virology; D060888:Real-Time Polymerase Chain Reaction; D016036:Seroepidemiologic Studies; D017201:Virus Shedding / Q000502:physiology; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral; D007155:Immunologic Factors; D000069442:Natalizumab
keywords: JC virus; Multiple sclerosis; Natalizumab; Seroprevalence; Urinary excretion