title: Increased prevalence of JC polyomavirus viruria was associated with arthritis/arthralgia in patients with systemic lupus erythematosus.
abstract: OBJECTIVE
  The objective of this paper is to investigate the prevalence of reactivation of the human polyomavirus John Cunningham virus (JCV) in patients with systemic lupus erythematosus (SLE) and its associated clinical manifestations.
  
  
  METHODS
  Sixty-one patients with SLE and 22 controls were enrolled. Urine JCV viral load was quantified by real-time polymerase chain reaction (PCR). Length variants of the VP1 gene were analyzed using capillary electrophoresis.
  
  
  RESULTS
  The prevalence of JCV viruria (63.9% vs. 18.2%, p < 0.001) and urine JCV viral load (2.92 ± 2.76 vs. 0.81 ± 1.85 copies/ml by log10 scale, p < 0.001) were significantly higher in patients with SLE compared with controls. JCV viruria (+) SLE patients had a higher occurrence of arthritis/arthralgia compared with JCV viruria (-) SLE patients (64.1% vs. 22.7%, p = 0.003). In SLE patients, the urine JCV viral load was significantly associated with the occurrence of arthritis/arthralgia. SLE patients with urine JCV viral load >10,000 copies/ml exhibited a 12.75-fold (95% confidence interval 2.88-56.40) risk in clinical arthritis/arthralgia, 18.90-fold (95% confidence interval 2.10-170.39) risk in persistent arthritis, and significantly greater number of length variants in the VP1 gene of JCV compared with JCV viruria (-) SLE patients.
  
  
  CONCLUSIONS
  Reactivation of JCV in the urinary tract of SLE patients was very common. Both JCV viruria and urine JCV viral load were associated with the occurrence of arthritis/arthralgia in patients with SLE. High urine JCV viral load also was associated with the genetic variant in the VP1 gene.
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: M-C
authors.initials: MC
authors.lastname: Lu
authors.affiliation: School of Medicine, Tzu Chi University, Hualien, Taiwan Division of General Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
authors.forename: W-Y
authors.initials: WY
authors.lastname: Yin
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
authors.forename: S-Q
authors.initials: SQ
authors.lastname: Liu
authors.affiliation: Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Koo
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
authors.forename: C-H
authors.initials: CH
authors.lastname: Tung
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: K-Y
authors.initials: KY
authors.lastname: Huang
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan School of Medicine, Tzu Chi University, Hualien, Taiwan tzuchilai@gmail.com.
authors.forename: N-S
authors.initials: NS
authors.lastname: Lai
mesh_terms: D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000652:urine / Q000821:virology*; D001168:Arthritis / Q000652:urine / Q000821:virology*; D036022:Capsid Proteins / Q000235:genetics / Q000378:metabolism; D016022:Case-Control Studies; D004279:DNA, Viral / Q000235:genetics / Q000652:urine; D019075:Electrophoresis, Capillary / Q000379:methods; D005260:Female; D006801:Humans; D007577:JC Virus / Q000235:genetics / Q000302:isolation & purification*; D008180:Lupus Erythematosus, Systemic / Q000652:urine / Q000821:virology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D027601:Polyomavirus Infections / Q000652:urine / Q000821:virology*; D015995:Prevalence; D017422:Sequence Analysis, DNA; D014775:Virus Activation
chemical_list: D036022:Capsid Proteins; D004279:DNA, Viral; C062481:VP1 protein, polyomavirus
keywords:     VP1 gene; Polyomavirus JC; arthritis; systemic lupus erythematosus