Possible patient to patient transmission of progressive multifocal leukoencephalopathy among kidney-transplant patients

Lajaunie, Rébecca; Mengelle, Catherine; Kamar, Nassim; Bello, Arnaud Del

doi:10.1016/j.bjid.2020.07.004

Cited by 1 publication

(2 citation statements)

References 5 publications

(5 reference statements)

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“…A PCR of the CSF yielded positive results, showing 911,175 copies/mL [56]. Lajaunie et al provided some evidence for the person-to-person transmission of PML by JCV in a clinical setting among three transplant patients (two, five, and eleven years post-transplantation), treated with combination therapies, including tacrolimus, mycophenolic acid belatacept, and steroids [57]. However, the confirmation of JCV sequences from viruses isolated from these patients was not performed [57].…”

Section: Transplant Patientsmentioning

confidence: 99%

“…Lajaunie et al provided some evidence for the person-to-person transmission of PML by JCV in a clinical setting among three transplant patients (two, five, and eleven years post-transplantation), treated with combination therapies, including tacrolimus, mycophenolic acid belatacept, and steroids [57]. However, the confirmation of JCV sequences from viruses isolated from these patients was not performed [57]. The JCV normal sites of latency, including the kidney and bone marrow, may result in the virus reaction after immunosuppression for transplantation.…”

Section: Transplant Patientsmentioning

confidence: 99%

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JC Polyomavirus and Transplantation: Implications for Virus Reactivation after Immunosuppression in Transplant Patients and the Occurrence of PML Disease

Hildreth

Alcendor

2021

Transplantology

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The JC polyomavirus (JCPyV/JCV) is a member of the Polyomaviridae family and is ubiquitious in the general population, infecting 50–80% of individuals globally. A primary infection with JCV usally results in an asymptomatic, persistent infection that establishes latency in the renourinary tract. Reactivation from latency via iatrogenic immununosuppression for allograft transplantation may result in organ pathology and a potential life-threatening neuropathological disease in the form of progressive multifocal leukoencephalopathy (PML). Currently, no treatment exists for PML, a rare complication that occurs after transplantation, with an incidence of 1.24 per 1000 persons a year among solid organ transplant patients. PML is also observed in HIV patients who are immununosuppressed and are not receiving antiretroviral therapy, as well as individuals treated with biologics to suppress chronic inflammatory responses due to multiple sclerosis, Crohn’s disease, non-Hodgkin’s lymphoma, rheumatoid arthritis, and other autoimmune-mediated hematological disorders. Here, we describe the proposed mechanisms of JCV reactivation as it relates to iatrogenic immunosuppression for graft survival and the treatment of proinflammatory disease, such as biologics, proposed trafficking of JCV from the renourinary tract, JCV central nervous system dissemination and the pathology of PML in immunosuppressed patients, and potential novel therapeutics for PML disease.

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Section: Transplant Patientsmentioning

confidence: 99%

Section: Transplant Patientsmentioning

confidence: 99%