Study of the anti-JCV antibody levels in a Spanish multiple sclerosis cohort.
Autor: Dominguez-Mozo, M.I.; Rus, M.; Santiago, J.L.; Izquierdo, G.; Casanova, Ignacio; Galan, V.; Garcia-Martinez, M.A.; Arias-Leal, A.M.; García-Montojo, M.; Pérez-Pérez, S.; Arroyo, R.; Alvarez-Lafuente, R.
Resumen: Background One of the risk factor to develop progressive multifocal leukoencephalopathy (PML) among
natalizumab-treated patients is the presence and high levels of anti-JCV antibodies. Our purpose was to test the
association of different clinical and demographic variables with the presence and levels of anti-JCV antibodies in
a Spanish cohort of patients with multiple sclerosis (MS) during natalizumab treatment.
Materials and methods All patients with MS from two hospitals with at least one measure of the anti-JCV
antibodies levels (2011–2014) were recruited, among them were two PML cases. Anti-JCV antibody levels were
assessed using two-step ELISA.
Results A total of 1061 patients (16 3% natalizumab-treated) participated in this study. The seropositivity rate of
anti-JCV antibodies was 58 2%. It increased with age (Pcorrected = 0 00005) and was lower among HLADRB1*
15:01 carriers (Pcorrected = 0 049). The two patients with PML were HLA-DRB1*15:01 carriers. We had at
least three quarterly anti-JCV antibody measurements (index value) from 137 patients, whose levels did not
increase during natalizumab treatment. However, 5 8% of these patients had an increase of the index value
higher of one point in a maximum of 6 months, something that was more frequently observed (P = 0 054)
among patients treated with immunosuppressant prior to natalizumab onset.
Conclusions Old age and HLA-DRB1*15:01 were the factors that influence positively and negatively, respectively,
our anti-JCV antibody prevalence, although our both PML cases were HLA-DRB1*15:01carriers. Most of
our patients showed a stable anti-JCV antibody index values during natalizumab treatment.
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- MEDICINA [819]