Asymptomatic Reactivation of JC Virus in Patients Treated with Natalizumab

doi:10.1056/nejmc0909622

Cited by 19 publications

(1 citation statement)

References 24 publications

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“…In this current study we did not detect DNA from KIPyV, WUPyV, and MCPyV in the same samples in these patients. Although JCPyV reactivation in natalizumab treated MS patients remains controversial [18], results in this study suggested that there was no co-reactivation of new PyVs with JCPyV in our cohort of MS patients treated with natalizumab. These results also provide evidences that the pathogenesis of these three new polyomaviruses may be more closely related to BKPyV than JCPyV.…”

Section: Discussionmentioning

confidence: 49%

Infrequent Detection of KI, WU and MC Polyomaviruses in Immunosuppressed Individuals with or without Progressive Multifocal Leukoencephalopathy

et al. 2011

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Conflicting prevalence of newly identified KI(KIPyV), WU(WUPyV) and Merkel Cell Carcinoma(MCPyV) polyomaviruses have been reported in progressive multifocal leukoencephalopathy(PML) patient samples, ranging from 0 to 14.3%. We analyzed the prevalence of these polyomaviruses in cerebrospinal fluid(CSF), peripheral blood mononuclear cells(PBMC), and bone marrow samples from PML patients, immunosuppressed individuals with or without HIV, and multiple sclerosis(MS) patients. Distinct PCR tests for KIPyV, WUPyV and MCPyV DNA performed in two independent laboratories detected low levels of MCPyV DNA only in 1/269 samples. The infrequent detections of these viruses in multiple samples from immunosuppressed individuals including those with PML suggest that their reactivation mechanisms may be different from that of JC polyomavirus (JCPyV) and that they do not play a role in the pathogenesis of PML.

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Section: Discussionmentioning

confidence: 49%

Infrequent Detection of KI, WU and MC Polyomaviruses in Immunosuppressed Individuals with or without Progressive Multifocal Leukoencephalopathy

et al. 2011

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Natalizumab and Progressive Multifocal Leukoencephalopathy

Warnke¹,

Menge²,

Hartung³

et al. 2010

Arch Neurol

107

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atalizumab (Tysabri) was the first monoclonal antibody approved for the treatment of relapsing forms of multiple sclerosis (MS). After its initial approval, 3 patients undergoing natalizumab therapy in combination with other immunoregulatory and immunosuppressive agents were diagnosed with progressive multifocal leukoencephalopathy (PML). The agent was later reapproved and its use restricted to monotherapy in patients with relapsing forms of MS. Since reapproval in 2006, additional cases of PML were reported in patients with MS receiving natalizumab monotherapy. Thus, there is currently no convincing evidence that natalizumab-associated PML is restricted to combination therapy with other diseasemodifying or immunosuppressive agents. In addition, recent data indicate that risk of PML might increase beyond 24 months of treatment.

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