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We thank Tiffany VanCleve, BS, (Department of Pathology, St Jude Children's Research Hospital) for her technical assistance with this project and Brent Seaton, PhD, (Focus Diagnostics, Cypress, California) for his support in providing control JC virus material.
Human immunodeficiency virus (HIV) and JC virus in acquired immune deficiency syndrome (AIDS) patients with progressive multifocal leukoencephalopathy.
Polymerase chain reaction for the JC virus has a sensitivity of 70%-90% and a specificity approaching 100%.
Despite some initial optimism that plasma JC viral DNA levels would be useful in detecting PML early, its sensitivity and positive predictive values are uncertain, and while CSF testing for JC virus is specific at the time of diagnosis, the literature indicates that it tends to be negative in early disease and it is invasive; so it is not considered to be a good screening tool, he explained.
However, in many cases, confirmatory clinical symptoms, CSF polymerase chain reaction (PCR) studies that are positive for the JC virus, and appropriate imaging findings may be sufficient for making a treatment decision, and biopsy can be avoided.
1] In HIV-positive patients during the pre-HAART (highly active antiretroviral therapy) era, infection by the JC virus in the brain with PML was rapidly fatal, with a median survival of 3 - 6 months; up to 5% of HIV-positive patients eventually succumbed to PML.
Focus Diagnostics also offers molecular primer pairs for the development of laboratory tests, including JC virus, Varicella-Zoster Virus (VZV), adenovirus and human herpesvirus-6 (HHV-6).
It has been hypothesized that specific TCR sequence variations may be related to increased replication activity and infectiousness, as reported for the other member of the human polyomavirus (PV) family, and that JC virus (JCV), in what is called a progressive multifocal leukoencephalopathy-like rearrangement, is required for the development of progressive multifocal leukoencephalopathy (PML).
The statement noted that PML is a viral infection of the brain caused by activation of latent JC virus in the body.
It is caused by the activation of a human polyomavirus, JC virus, which is latent in more than 80% of healthy adults, and can be similar in presentation to MS although the cause of demyelination differs.
The applications request an expanded indication that would include first-line use for people living with certain relapsing forms of multiple sclerosis (MS) who have tested negative for antibodies to the JC virus (JCV).
Stratifying PML Risk in Multiple Sclerosis : These study findings will help clinicians faced with the difficult choice about how to manage patients with MS on Tysabri who become positive for JC virus antibodies or are already positive for these antibodies.