Harypursat Vijay, Zhou Yihong, Tang Shengquan, Chen Yaokai
Division of Infectious Diseases, Chongqing Public Health Medical Center, 109 Baoyu Road, Geleshan Town, Shapingba District, Chongqing, 400036, People's Republic of China.
AIDS Res Ther. 2020 Jul 6;17(1):37. doi: 10.1186/s12981-020-00293-0.
The human neurotropic virus JC Polyomavirus, a member of the Polyomaviridae family, is the opportunistic infectious agent causing progressive multifocal leukoencephalopathy, typically in immunocompromised individuals. The spectrum of underlying reasons for the systemic immunosuppression that permits JCV infection in the central nervous system has evolved over the past 2 decades, and therapeutic immunosuppression arousing JCV infection in the brain has become increasingly prominent as a trigger for PML. Effective immune restoration subsequent to human immunodeficiency virus-related suppression is now recognized as a cause for unexpected deterioration of symptoms in patients with PML, secondary to a rebound inflammatory phenomenon called immune reconstitution inflammatory syndrome, resulting in significantly increased morbidity and mortality in a disease already infamous for its lethality. This review addresses current knowledge regarding JC Polyomavirus, progressive multifocal leukoencephalopathy, progressive multifocal leukoencephalopathy-related immune reconstitution inflammatory syndrome, and the immunocompromised states that incite JC Polyomavirus central nervous system infection, and discusses prospects for the future management of these conditions.
人嗜神经病毒JC多瘤病毒是多瘤病毒科的成员，是引起进行性多灶性白质脑病的机会性感染病原体，通常发生在免疫功能低下的个体中。在过去20年中，导致中枢神经系统发生JC病毒感染的全身免疫抑制的潜在原因范围有所演变，作为PML的触发因素，引起脑部JC病毒感染的治疗性免疫抑制变得越来越突出。目前认为，人类免疫缺陷病毒相关抑制后有效的免疫恢复是PML患者症状意外恶化的原因，这是由于一种称为免疫重建炎症综合征的反弹炎症现象所致，在一种已经因其致命性而臭名昭著的疾病中，导致发病率和死亡率显著增加。本综述阐述了关于JC多瘤病毒、进行性多灶性白质脑病、与进行性多灶性白质脑病相关的免疫重建炎症综合征以及引发JC多瘤病毒中枢神经系统感染的免疫功能低下状态的当前知识，并讨论了这些病症未来管理的前景。
