HIV-associated progressive multifocal leukoencephalopathy: current perspectives

Iannetta, Marco; Zingaropoli, Maria Antonella; D’Abramo, Alessandra; Oliva, Alessandra; Mastroianni, Claudio Maria; Vullo, Vincenzo; Ciardi, Maria Rosa

doi:10.2147/nbhiv.s107941

Cited by 7 publications

(21 citation statements)

References 77 publications

(115 reference statements)

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“…Moreover, MS patients showed a better prognosis, probably because of the discontinuation of the DMT and consequent immune reconstitution. Indeed, after DMT removal, MS patients with PML can experience an immune reconstitution syndrome (IRIS), which is similar to PML-IRIS occurring in some HIV patients after cART initiation [1].…”

Section: Discussionmentioning

confidence: 94%

“…Progressive multifocal leukoencephalopathy (PML) is a severe demyelinating disease of the central nervous system (CNS) caused by the human polyomavirus JC (JCPyV) [1]. Most of the people become seropositive to JCPyV during childhood, and JCPyV can persist and replicate asymptomatically in the urinary tract and in other organs [2].…”

Section: Introductionmentioning

confidence: 99%

“…During severe immunosuppression or treatment with disease-modifying therapies (DMTs), JCPyV may establish a lytic infection in oligodendrocytes, leading to PML [4,5]. AIDS represents the most common predisposing condition for PML development [1]. However, the introduction of combination antiretroviral therapies (cART) have reduced the PML risk in HIV-infected patients [1].…”

Section: Introductionmentioning

confidence: 99%

“…AIDS represents the most common predisposing condition for PML development [1]. However, the introduction of combination antiretroviral therapies (cART) have reduced the PML risk in HIV-infected patients [1]. To date, several DMTs used in multiple sclerosis (MS) have been associated with PML.…”

Section: Introductionmentioning

confidence: 99%

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JCPyV NCCR analysis in PML patients with different risk factors: exploring common rearrangements as essential changes for neuropathogenesis

Ciardi

Zingaropoli

Iannetta

et al. 2020

Virol J

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Background During severe immunosuppression or treatment with specific biological drugs, human polyomavirus JC (JCPyV) may establish a lytic infection in oligodendrocytes, leading to progressive multifocal leukoencephalopathy (PML). Beyond AIDS, which represents the most common predisposing condition, several biological drugs have been associated to the development of PML, such as natalizumab, fingolimod and dimethyl fumarate, which have been showed to increase the risk of PML in the multiple sclerosis (MS) population. JCPyV non-coding control region (NCCR) can be found in two different forms: a virulent neurotropic pathogenic form and a latent non-pathogenic form. The neurotropic forms contain a rearranged NCCR and are typically found in the cerebrospinal fluid, brain or blood of PML patients. Case presentation We sequenced and critically examined JCPyV NCCR from isolates detected in the cerebrospinal fluid of four newly diagnosed progressive multifocal leukoencephalopathy patients: two HIV-positive and two HIV-negative multiple sclerosis patients. More complex NCCR rearrangements were observed in the two HIV-positive patients compared to the HIV-negative multiple sclerosis patients with PML. Conclusions The comparison of HIV-positive and HIV-negative MS patients with PML, allowed us to evidence the presence of a common pattern of JCPyV NCCR rearrangement, characterized by the deletion of the D-block, which could be one of the initial rearrangements of JCPyV NCCR needed for the development of PML.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

JCPyV NCCR analysis in PML patients with different risk factors: exploring common rearrangements as essential changes for neuropathogenesis

Ciardi

Zingaropoli

Iannetta

et al. 2020

Virol J

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“…Clinical and radiological features sustain the diagnosis along with detection of JCV in the cerebrospinal fluid (CSF). The majority of HIV patients diagnosed with PML have CD4+ counts <200 cells/µL 1 .…”

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confidence: 99%