title: Is there a (host) genetic predisposition to progressive multifocal leukoencephalopathy?
abstract: Progressive multifocal leukoencephalopathy (PML) has been described in association with a variety of predisposing risk factors, including HIV/AIDS, lymphoproliferative disorders and, most recently, treatment with a range of biologics, most notably natalizumab in multiple sclerosis (MS) (1). However, while these underlying disorders appear to be (usually) necessary, they are not sufficient to predict the development of PML, since only a small fraction of such individuals will succumb, raising the question of whether host genetic factors must also play a role. Evidence is mounting that this is, indeed, the case but more work needs to be done to fully delineate these underlying genetic factors. Finally, while it is possible that an underlying genetic susceptibility for PML in general will be uncovered in the future, the current evidence argues for a collection of multiple, individually rare underlying susceptibilities (with one predominant single genetic susceptibility in each individual), as described in this review.
authors.affiliation: Population Diagnostics UK, Inc., Begbroke Science Park , Begbroke, Oxfordshire , UK.
authors.forename: Eli
authors.initials: E
authors.lastname: Hatchwell
keywords: PML predisposition; host genetic factors; natalizumab; primary immunodeficiencies; progressive multifocal leukoencephalopathy