当前位置： SCI文献检索 > JOURNAL OF NEUROVIROLOGY期刊下所有文献 > Reactivation of BK polyomavirus in patients with multiple sclerosis receiving natalizumab therapy.

Reactivation of BK polyomavirus in patients with multiple sclerosis receiving natalizumab therapy.

Abstract：

:Natalizumab therapy in multiple sclerosis has been associated with JC polyomavirus-induced progressive multifocal leucoencephalopathy. We hypothesized that natalizumab may also lead to reactivation of BK, a related human polyomavirus capable of causing morbidity in immunosuppressed groups. Patients with relapsing remitting multiple sclerosis treated with natalizumab were prospectively monitored for reactivation of BK virus in blood and urine samples, and for evidence of associated renal dysfunction. In this cohort, JC and BK DNA in blood and urine; cytomegalovirus (CMV) DNA in blood and urine; CD4 and CD8 T-lymphocyte counts and ratios in peripheral blood; and renal function were monitored at regular intervals. BK subtyping and noncoding control region sequencing was performed on samples demonstrating reactivation. Prior to commencement of natalizumab therapy, 3 of 36 patients with multiple sclerosis (8.3%) had BK viruria and BK reactivation occurred in 12 of 54 patients (22.2%). BK viruria was transient in 7, continuous in 2 patients, and persistent viruria was associated with transient viremia. Concomitant JC and CMV viral loads were undetectable. CD4:CD8 ratios fluctuated, but absolute CD4 counts did not fall below normal limits. In four of seven patients with BK virus reactivation, transient reductions in CD4 counts were observed at onset of BK viruria: these resolved in three of four patients on resuppression of BK replication. No renal dysfunction was observed in the cohort. BK virus reactivation can occur during natalizumab therapy; however, the significance in the absence of renal dysfunction is unclear. We propose regular monitoring for BK reactivation or at least for evidence of renal dysfunction in patients receiving natalizumab.

journal_name

J Neurovirol

journal_title

Journal of neurovirology

authors

Lonergan RM,Carr MJ,De Gascun CF,Costelloe LF,Waters A,Coughlan S,Duggan M,Doyle K,Jordan S,Hutchinson MW,Hall WW,Tubridy NJ

doi

10.3109/13550280903131923

subject

Has Abstract

pub_date

2009-09-01 00:00:00

pages

351-9

issue

5-6

eissn

1355-0284

issn

1538-2443

pii

913775658

journal_volume

pub_type

杂志文章

在线工具

Reactivation of BK polyomavirus in patients with multiple sclerosis receiving natalizumab therapy.