title: Polyomavirus detection in multiple sclerosis patients under natalizumab therapy: Profile and frequency of urinary shedding.
abstract: Patients undergoing Natalizumab (NTZ) therapy are at risk of progressive multifocal leukoencephalopathy (PML). Besides John Cunningham virus (JCV), BK polyomavirus might represent an additional concern for such patients since it can also infect CNS cells. Currently, data regarding the presence of anti-JCV antibodies added to previous immunosuppressive therapy and prolonged NTZ therapy has been used to classify patients at risk of developing PML. Here, we investigated the profile shedding of JCV and BKV in multiple sclerosis (MS) patients during treatment with NTZ. Serial blood and urine samples from 97 MS patients receiving either NTZ or β-interferon were investigated for polyomavirus shedding. While all blood samples tested negative, 36% of the patients shed polyomavirus in the urine in at least one time point. From these, 21.7%, 9.3%, and 5.1% shed JCV, BKV, and both polyomavirus, respectively. No difference was observed between the rates of urinary shedding of patients treated with NTZ (38.9%) and patients treated with other drugs (34.5%), also no PML event was diagnosed during the follow-up. Therefore, urinary shedding might not be interfered by therapy condition. In our study, we also observed 14/27 (52%) of anti-JCV antibodies prevalence, and nearly half of them (42%) did not present any event of urinary shedding during the follow-up. J. Med. Virol. 89:528-534, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Laboratório de Virologia, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Luiz Henrique
authors.initials: LH
authors.lastname: Nali
authors.affiliation: Laboratório de Virologia, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Fink
authors.affiliation: Laboratório de Virologia, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil.|Departamento de Neurologia, Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
authors.forename: Guilherme S
authors.initials: GS
authors.lastname: do Olival
authors.affiliation: Hospital das Clínicas de São Paulo-HCFMUSP, São Paulo, Brazil.
authors.forename: Lenira
authors.initials: L
authors.lastname: Moraes
authors.affiliation: Hospital das Clínicas de São Paulo-HCFMUSP, São Paulo, Brazil.
authors.forename: Dagoberto
authors.initials: D
authors.lastname: Callegaro
authors.affiliation: Departamento de Neurologia, Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
authors.forename: Charles Peter
authors.initials: CP
authors.lastname: Tilbery
authors.affiliation: Grupo de Neurociências, Instituto de Infectologia Emílio Ribas, São Paulo, Brazil.
authors.forename: Jose Ernesto
authors.initials: JE
authors.lastname: Vidal
authors.affiliation: Laboratório de Virologia, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Laura Masami
authors.initials: LM
authors.lastname: Sumita
authors.affiliation: Departamento de Neurologia, Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.|Grupo de Neurociências, Instituto de Infectologia Emílio Ribas, São Paulo, Brazil.
authors.forename: Augusto C Penalva
authors.initials: AC
authors.lastname: de Oliveira
authors.affiliation: Laboratório de Virologia, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Camila M
authors.initials: CM
authors.lastname: Romano
mesh_terms: D001739:BK Virus / Q000302:isolation & purification*; D001769:Blood / Q000821:virology; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects; D009103:Multiple Sclerosis / Q000150:complications / Q000188:drug therapy*; D000069442:Natalizumab / Q000008:administration & dosage* / Q000009:adverse effects; D027601:Polyomavirus Infections / Q000821:virology*; D014556:Urine / Q000821:virology; D017201:Virus Shedding
chemical_list: D007155:Immunologic Factors; D000069442:Natalizumab
keywords: BKV; JCV; multiple sclerosis; natalizumab; progressive multifocal leukoencephalopathy; risk stratification