Hegen Harald, Auer Michael, Bsteh Gabriel, Di Pauli Franziska, Plavina Tatiana, Walde Janette, Deisenhammer Florian, Berger Thomas
Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Biogen, Cambridge, Massachusetts, United States of America.
PLoS One. 2017 Mar 20;12(3):e0174005. doi: 10.1371/journal.pone.0174005. eCollection 2017.
Risk of natalizumab-related progressive multifocal leukoencephalopathy is associated with the presence of anti-JC-virus (JCV) antibodies.
To investigate the longitudinal evolution of anti-JCV antibody index and to determine the predictive value of baseline anti-JCV antibody index for long-term stability of anti-JCV antibody status.
MS patients from the MS centre of Medical University of Innsbruck, who had serum sampling for a time period of 4-6 years at intervals of 6±3 months, were included in this retrospective, longitudinal study. Anti-JCV antibody serological status and index were determined by 2-step second-generation anti-JCV antibody assay.
154 patients were included in this study. Median follow-up time was 63.7 months, with median 11 samples available per patient. At baseline, 111 (72.1%) patients were anti-JCV antibody positive. Baseline anti-JCV antibody index significantly correlated with age (R = 0.22, p = 0.005); there was no difference with respect to sex, disease duration or previously used disease-modifying treatment. During follow-up anti-JCV antibody status changed from negative to positive or vice versa in 17% of patients. In seronegative patients at baseline, baseline anti-JCV antibody index was significantly lower in those remaining seronegative at follow-up compared to those converting to seropositivity (median 0.16 vs. 0.24, p = 0.002). In seropositive patients at baseline, index was higher in those remaining seropositive compared to those reverting to seronegativity (2.6 vs. 0.45, p<10-7). Baseline anti-JCV antibody index >0.90 predicted stable positive serostatus (sensitivity 88.7%, specificity 96.5%) and <0.20 stable negative serostatus (sensitivity 61.3%, specificity 97.6%).
Anti-JCV antibody index remained relatively stable over 6-year follow-up with annual serostatus change of ~3%. Baseline anti-JCV antibody index predicted stable negative and stable positive JCV serostatus.
那他珠单抗相关的进行性多灶性白质脑病风险与抗 JC 病毒（JCV）抗体的存在有关。
研究抗 JCV 抗体指数的纵向演变，并确定基线抗 JCV 抗体指数对抗 JCV 抗体状态长期稳定性的预测价值。
来自因斯布鲁克医科大学多发性硬化症中心的多发性硬化症患者纳入了这项回顾性纵向研究，这些患者在 4 - 6 年的时间里每隔 6±3 个月进行一次血清采样。抗 JCV 抗体血清学状态和指数通过两步法第二代抗 JCV 抗体检测来确定。
本研究纳入了 154 名患者。中位随访时间为 63.7 个月，每位患者中位有 11 份样本。基线时，111 名（72.1%）患者抗 JCV 抗体呈阳性。基线抗 JCV 抗体指数与年龄显著相关（R = 0.22，p = 0.005）；在性别、疾病持续时间或先前使用的疾病修饰治疗方面没有差异。随访期间，17%的患者抗 JCV 抗体状态从阴性变为阳性或反之。在基线时血清阴性的患者中，随访时仍为血清阴性的患者基线抗 JCV 抗体指数显著低于转为血清阳性的患者（中位数 0.16 对 0.24，p = 0.002）。在基线时血清阳性的患者中，仍为血清阳性的患者指数高于恢复为血清阴性的患者（2.6 对 0.45，p<10 - 7）。基线抗 JCV 抗体指数>0.90 预测血清学状态稳定为阳性（敏感性 88.7%，特异性 96.5%），<0.20 预测血清学状态稳定为阴性（敏感性 61.3%，特异性 97.6%）。
在 6 年的随访中，抗 JCV 抗体指数保持相对稳定，每年血清学状态变化约为 3%。基线抗 JCV 抗体指数可预测 JCV 血清学状态稳定为阴性和阳性。
