TY - JOUR
T1 - Highly active antiretroviral therapy and progressive multifocal leukoencephalopathy
T2 - Effects on cerebrospinal fluid markers of JC virus replication and immune response
AU - Giudici, Barbara
AU - Vaz, Beatriz
AU - Bossolasco, Simona
AU - Casari, Salvatore
AU - Brambilla, Anna Maria
AU - Lüke, Wolfgang
AU - Lazzarin, Adriano
AU - Weber, Thomas
AU - Cinque, Paola
PY - 2000
Y1 - 2000
N2 - Cerebrospinal fluid (CSF) samples were examined from 7 patients infected with human immunodeficiency virus type 1 (HIV-1) who had progressive multifocal leukoencephalopathy (PML). Samples were obtained both before and after 35-365 days of highly active antiretroviral therapy (HAART). By polymerase chain reaction, JC virus (JCV) DNA was found in 6 of 7 patients at baseline but in only 1 patient after HAART. In contrast, in 25 historical control patients from whom sequential CSF specimens were obtained, no reversion from detectable to undetectable JCV DNA was observed. By use of enzyme-linked immunosorbent assay, intrathecal production of antibody to JCV- VP1 was shown in only 1 of 4 HAART recipients at baseline but in 5 of 5 patients after treatment. The neuroradiological picture improved or had stabilized in all patients after 12 months of HAART, and all were alive after a median of 646 days (range, 505-775 days). Prolonged survival after HAART for PML is associated with JCV clearance from CSF. JCV-specific humoral intrathecal immunity may play a role in this response.
AB - Cerebrospinal fluid (CSF) samples were examined from 7 patients infected with human immunodeficiency virus type 1 (HIV-1) who had progressive multifocal leukoencephalopathy (PML). Samples were obtained both before and after 35-365 days of highly active antiretroviral therapy (HAART). By polymerase chain reaction, JC virus (JCV) DNA was found in 6 of 7 patients at baseline but in only 1 patient after HAART. In contrast, in 25 historical control patients from whom sequential CSF specimens were obtained, no reversion from detectable to undetectable JCV DNA was observed. By use of enzyme-linked immunosorbent assay, intrathecal production of antibody to JCV- VP1 was shown in only 1 of 4 HAART recipients at baseline but in 5 of 5 patients after treatment. The neuroradiological picture improved or had stabilized in all patients after 12 months of HAART, and all were alive after a median of 646 days (range, 505-775 days). Prolonged survival after HAART for PML is associated with JCV clearance from CSF. JCV-specific humoral intrathecal immunity may play a role in this response.
UR - http://www.scopus.com/inward/record.url?scp=0033956614&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033956614&partnerID=8YFLogxK
U2 - 10.1086/313598
DO - 10.1086/313598
M3 - Article
C2 - 10619739
AN - SCOPUS:0033956614
VL - 30
SP - 95
EP - 99
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 1
ER -