Laboratório de Virologia, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil.
Departamento de Neurologia, Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
J Med Virol. 2017 Mar;89(3):528-534. doi: 10.1002/jmv.24646. Epub 2016 Aug 9.
Patients undergoing Natalizumab (NTZ) therapy are at risk of progressive multifocal leukoencephalopathy (PML). Besides John Cunningham virus (JCV), BK polyomavirus might represent an additional concern for such patients since it can also infect CNS cells. Currently, data regarding the presence of anti-JCV antibodies added to previous immunosuppressive therapy and prolonged NTZ therapy has been used to classify patients at risk of developing PML. Here, we investigated the profile shedding of JCV and BKV in multiple sclerosis (MS) patients during treatment with NTZ. Serial blood and urine samples from 97 MS patients receiving either NTZ or β-interferon were investigated for polyomavirus shedding. While all blood samples tested negative, 36% of the patients shed polyomavirus in the urine in at least one time point. From these, 21.7%, 9.3%, and 5.1% shed JCV, BKV, and both polyomavirus, respectively. No difference was observed between the rates of urinary shedding of patients treated with NTZ (38.9%) and patients treated with other drugs (34.5%), also no PML event was diagnosed during the follow-up. Therefore, urinary shedding might not be interfered by therapy condition. In our study, we also observed 14/27 (52%) of anti-JCV antibodies prevalence, and nearly half of them (42%) did not present any event of urinary shedding during the follow-up. J. Med. Virol. 89:528-534, 2017. © 2016 Wiley Periodicals, Inc.
接受那他珠单抗（NTZ）治疗的患者存在进行性多灶性白质脑病（PML）的风险。除了约翰·坎宁安病毒（JCV）之外，BK 多瘤病毒也可能成为此类患者的另一个关注点，因为它也可以感染中枢神经系统细胞。目前，有关添加了先前免疫抑制治疗和延长 NTZ 治疗的抗 JCV 抗体的数据已被用于对发生 PML 的风险患者进行分类。在此，我们研究了 NTZ 治疗期间多发性硬化症（MS）患者 JCV 和 BKV 的脱落情况。对 97 名接受 NTZ 或 β-干扰素治疗的 MS 患者的连续血液和尿液样本进行了多瘤病毒脱落情况的检测。虽然所有血液样本均为阴性，但 36%的患者至少有一次尿液中排出多瘤病毒。其中，21.7%、9.3%和 5.1%分别排出 JCV、BKV 和两种多瘤病毒。接受 NTZ 治疗的患者（38.9%）和接受其他药物治疗的患者（34.5%）的尿液脱落率没有差异，随访期间也未诊断出 PML 事件。因此，尿液脱落情况可能不受治疗情况的影响。在我们的研究中，我们还观察到 27 例患者中有 14 例（52%）存在抗 JCV 抗体，其中近一半（42%）在随访期间没有出现任何尿液脱落事件。医学病毒学杂志 89:528-534, 2017. © 2016 Wiley Periodicals, Inc.
