静脉注射免疫球蛋白会干扰血清中 JC 病毒抗体的检测结果。
IV immunoglobulin confounds JC virus antibody serostatus determination.
机构信息
NYU Multiple Sclerosis Care Center (I.K., M.O., J.H.), Department of Neurology, NYU School of Medicine, New York, NY; Barnabas Multiple Sclerosis Care Center (I.K., M.Y., J.H.), Department of Medicine, Barnabas Medical Center, Livingston, NJ; Biogen Idec (G.K., M.S.), Cambridge, MA; Department of Epidemiology (E.C.), University of Alabama at Birmingham School of Public Health, Birmingham, AL; and Specialized Clinical Services (K.D.), Park Ridge, NJ.
出版信息
Neurol Neuroimmunol Neuroinflamm. 2014 Sep 18;1(3):e29. doi: 10.1212/NXI.0000000000000029. eCollection 2014 Oct.
OBJECTIVE
To determine the impact of therapeutic infusion of IV immunoglobulin (IVIg) on John Cunningham virus antibody (JCV Ab) serostatus and level in serum.
METHODS
We carried out a retrospective analysis of serum levels of JCV Ab among STRATIFY-2 trial enrollees from 2 multiple sclerosis centers who were exposed to IVIg during the trial. For the subset of eligible patients, we estimated mean linear trends while on IVIg and after stopping IVIg with a linear mixed-effects model.
RESULTS
The JCV Ab seropositivity rate in the group of patients that was recently exposed to IVIg was 100%, which is significantly higher than in the IVIg-naive population (58%, p < 0.001). The seropositivity rate in the patient group with remote IVIg exposure was similar to that in the IVIg-naive population (67%, p = 0.68, Fisher exact test). The slope of the linear trend line after stopping IVIg decreased significantly by -0.310 units per 100 days (95% confidence interval, -0.611 to -0.008; p = 0.04).
CONCLUSIONS
Recent IVIg exposure is invariably associated with JCV Ab seropositivity. After stopping IVIg, JCV Ab levels tend to decrease with time, and seroreversion to innately Ab-negative status can occur.
目的
确定静脉注射免疫球蛋白（IVIg）治疗输注对血清中约翰·坎宁安病毒抗体（JCV Ab）血清状态和水平的影响。
方法
我们对来自 2 个多发性硬化症中心的 STRATIFY-2 试验入组者在试验期间接受 IVIg 治疗时的 JCV Ab 血清水平进行了回顾性分析。对于符合条件的患者亚组，我们使用线性混合效应模型估计了在接受 IVIg 治疗期间和停止 IVIg 治疗后的平均线性趋势。
结果
最近接受 IVIg 治疗的患者组的 JCV Ab 血清阳性率为 100%，明显高于 IVIg 未暴露人群（58%，p<0.001）。有远程 IVIg 暴露史的患者组的血清阳性率与 IVIg 未暴露人群相似（67%，p=0.68，Fisher 确切检验）。停止 IVIg 后，线性趋势线的斜率显著下降了-0.310 个单位/100 天（95%置信区间，-0.611 至-0.008；p=0.04）。
结论
最近接受 IVIg 治疗与 JCV Ab 血清阳性率总是相关的。停止 IVIg 治疗后，JCV Ab 水平随时间趋于下降，并且可能会出现抗体自然阴性的血清逆转。
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