title: JC virus reactivation in patients with autoimmune rheumatic diseases treated with rituximab.
abstract: OBJECTIVE
  To evaluate the presence of John Cunningham virus (JCV) DNA in patients with autoimmune rheumatic diseases (ARDs) treated with rituximab (RTX).
  
  
  METHODS
  We assessed the JCV DNA levels in peripheral blood mononuclear cell (PBMC), serum, and urine samples by quantitative real-time polymerase chain reaction (qPCR) in a cohort of 42 ARD patients (20 of whom were being treated with RTX) and 42 healthy donors. Approximately 1 year later, we collected further samples from 32 of these 42 ARD patients, all of whom were being treated with RTX. We studied the association between these viral DNA prevalences and various clinical and demographic variables.
  
  
  RESULTS
  The viral prevalence in PBMC, serum, and urine samples was 2.4% (1/42), 0%, and 50% (21/42), respectively, in the healthy donors, and 26% (8/31), 16% (5/31), and 86% (25/29), respectively, in the patients treated with RTX. The viral prevalences were not associated with any of the demographic or clinical variables included in the study.
  
  
  CONCLUSIONS
  We detected a viral reactivation in PBMCs and serum during the RTX treatment that did not seem to be influenced by either use of immunosuppressive drugs or the length of treatment with the monoclonal antibody. Although this reactivation was asymptomatic, the viral presence in blood could increase the probability of the appearance of a neurotrophic variant of JCV.
authors.affiliation: a Departments of Neurology and Rheumatology , Health Research Institute, San Carlos Clinical Hospital (IDISSC) , Madrid , Spain.
authors.forename: M I
authors.initials: MI
authors.lastname: Domínguez-Mozo
authors.affiliation: a Departments of Neurology and Rheumatology , Health Research Institute, San Carlos Clinical Hospital (IDISSC) , Madrid , Spain.
authors.forename: E
authors.initials: E
authors.lastname: Toledano-Martínez
authors.affiliation: a Departments of Neurology and Rheumatology , Health Research Institute, San Carlos Clinical Hospital (IDISSC) , Madrid , Spain.
authors.forename: L
authors.initials: L
authors.lastname: Rodríguez-Rodríguez
authors.affiliation: a Departments of Neurology and Rheumatology , Health Research Institute, San Carlos Clinical Hospital (IDISSC) , Madrid , Spain.
authors.forename: M
authors.initials: M
authors.lastname: García-Montojo
authors.affiliation: a Departments of Neurology and Rheumatology , Health Research Institute, San Carlos Clinical Hospital (IDISSC) , Madrid , Spain.
authors.forename: R
authors.initials: R
authors.lastname: Alvarez-Lafuente
authors.affiliation: a Departments of Neurology and Rheumatology , Health Research Institute, San Carlos Clinical Hospital (IDISSC) , Madrid , Spain.
authors.forename: B
authors.initials: B
authors.lastname: Fernández-Gutiérrez
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000821:virology; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000821:virology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007577:JC Virus / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D000069283:Rituximab / Q000009:adverse effects*; D014775:Virus Activation / Q000187:drug effects*
chemical_list: D018501:Antirheumatic Agents; D000069283:Rituximab