Division of Neurology, Amiri Hospital, Arabian Gulf Street, Sharq 13041, Kuwait; Neurology Clinic, Dasman Diabetes Institute, P.O. Box 1180, Dasman 15462, Kuwait.
Department of Community Medicine & Behavioural Sciences, Faculty of Medicine, University of Kuwait, PO Box 24923, Safat 13110, Kuwait.
Mult Scler Relat Disord. 2018 Feb;20:132-135. doi: 10.1016/j.msard.2018.01.016. Epub 2018 Jan 31.
Anti-JC virus (JCV) antibody testing has been used increasingly to stratify multiple sclerosis (MS) patients into different disease modifying therapies.
We assessed JCV serostatus stability longitudinally in MS patients who were regularly tested for anti-JCV antibody and examined the demographic and clinical factors associated with JCV serostatus.
The data of MS patients who were screened for anti-JCV antibody using the two-step second-generation ELISA were collected between 1st October 2014 and 31st October 2015 at the MS clinic, Kuwait. Demographics, disease characteristics and JCV serostatus, including antibody index (AI), were obtained for patients with at least 12-months of follow-up results. Stable JCV serostatus was defined as anti-JCV antibody status that remained consistently negative or positive throughout the observation period. A change in serostatus was confirmed by a follow-up test at 6 months. Patients were labeled as JCV seroconverters (negative to positive), JCV seroreverters (positive to negative) or intermittently seropositive.
This study included 168 MS patients with anti-JCV antibody results for at least 1 year. Mean age and mean disease duration were 33.4 ± 9.8 and 8.1 ± 5.6 years respectively. In this cohort, 94% (n = 158) patients received natalizumab treatment with a mean of 27.2 ± 13.8 infusions. JCV stable serostatus (positive or negative) was observed in 84.5% (n = 142) with a mean follow-up duration of 23.8 ± 7.0 months. In this longitudinal study, relatively high frequencies of seroconverters (11.5%), intermittently seropositive (9.7%) and seroreverters (3.6%) were recorded. Age, gender, disease duration and number of natalizumab infusions did not influence JCV serostatus stability. JCV seroconversion risk was low with persistent AI < 0.9 beyond 18 months of initial testing.
Anti-JCV antibody index at baseline predicted stable negative as well as stable positive JCV serostatus over the observational period. The AI < 0.9 appeared to have a significant implication in the longitudinal stability of JCV AI in patients who were intermittently seropositive.
抗巨细胞病毒（JCV）抗体检测已被越来越多地用于将多发性硬化症（MS）患者分层为不同的疾病修正治疗方法。
我们评估了定期接受抗 JCV 抗体检测的 MS 患者的 JCV 血清状态的纵向稳定性，并研究了与 JCV 血清状态相关的人口统计学和临床因素。
2014 年 10 月 1 日至 2015 年 10 月 31 日，在科威特的 MS 诊所，使用两步第二代 ELISA 对 MS 患者进行了 JCV 抗体筛查，收集了数据。对于至少有 12 个月随访结果的患者，获得了人口统计学、疾病特征和 JCV 血清状态，包括抗体指数（AI）。稳定的 JCV 血清状态定义为整个观察期间抗 JCV 抗体状态持续阴性或阳性。通过 6 个月的随访检测来确认血清状态的变化。将患者标记为 JCV 血清转化（阴性转为阳性）、JCV 血清逆转（阳性转为阴性）或间歇性血清阳性。
这项研究纳入了至少有 1 年抗 JCV 抗体结果的 168 名 MS 患者。平均年龄和平均病程分别为 33.4±9.8 岁和 8.1±5.6 年。在该队列中，94%（n=158）患者接受了那他珠单抗治疗，平均接受了 27.2±13.8 次输注。84.5%（n=142）患者的 JCV 血清状态稳定（阳性或阴性），平均随访时间为 23.8±7.0 个月。在这项纵向研究中，记录到相对较高频率的血清转化者（11.5%）、间歇性血清阳性者（9.7%）和血清逆转者（3.6%）。年龄、性别、病程和那他珠单抗输注次数均未影响 JCV 血清状态的稳定性。初始检测后 18 个月持续 AI<0.9 时，JCV 血清转化的风险较低。
基线时的抗 JCV 抗体指数预测了整个观察期间的稳定阴性和稳定阳性 JCV 血清状态。在间歇性血清阳性的患者中，AI<0.9 似乎对 JCV AI 的纵向稳定性具有重要意义。
