Plasma levels of JC virus are sensitive and specific for detecting and predicting progressive multifocal leukoencephalopathy in HIV patients

Abstract

Aims: HIV-1 infection represents the most common immunosuppressive condition associated with progressive multifocal leukoencephalopathy (PML). Materials & methods: Nested PCR and quantitative real-time PCR (qPCR) for JC virus (JCV) DNA was performed on serial plasma samples obtained from 14 HIV patients with PML and 27 matched controls. Results: JCV large T antigen (LT) DNA was detected via qPCR in 11 out of 14 (79%) PML patients at disease onset and four out of 27 (15%) controls (p < 0.001). JCV LT qPCR was associated with PML diagnosis, duration of known HIV infection, absence of a prior AIDS-defining illness and absence of combination antiretroviral therapy (p < 0.001; R2 = 0.35). JCV LT qPCR was more likely to be positive in the 8 months prior to PML diagnosis compared with earlier samples (p = 0.01). Conclusion: Detection of JCV DNA in plasma of HIV infected patients via qPCR may represent a valuable test for identifying patients at risk of developing PML.