Determination of JC virus non coding control region variants in cerebrolspinal fluid and urine of adult progressive multifocal leukoencephalopathy patients at the university teaching hosipital
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Date
2016
Authors
Mubanga, Eugene
Journal Title
Journal ISSN
Volume Title
Publisher
University of Zambia
Abstract
John Cunningham virus (JC virus) is a polyomavirus that causes Progressive
Multifocal Leukoencephalopathy (PML) a debilitating and often fatal disease of the central
nervous system. JC virus is ubiquitous, approximately 50% of adults globally have antibodies
against the virus and about 30% actively shed the virus in urine. PML develops in patients
with immunological impairment such as those infected with Human Immunodeficiency Virus
(HIV), patients with hematological malignancies and recipients of immunosuppressive drugs.
JC virus has two variants archetype and rearranged which significantly play a critical role in
the development of PML. This study was carried out to determine the JC virus variants
present in cerebrospinal fluid (CSF) and urine of adult PML patients at the University
Teaching Hospital.
This was a cross-sectional study of adult patients at the University Teaching
Hospital (UTH) who presented with symptoms of central nervous system infections requiring
a lumbar puncture and met the inclusion criteria. A total of 326 patients who submitted urine
and blood samples besides the CSF were enrolled. Polymerase chain reaction (PCR) to detect
JC virus was done on all the CSF samples using the Corbett rotorgene thermal cycler. A
second PCR on urine and CSF samples was done on all JC virus positive CSF using primers
that detect JC virus archetype variant.
Two hundred and seventy five (275) of the 326 were human immunodeficiency
virus HIV antibody positive. Five (5) of the sampled CSF had detectable JC virus DNA. All
the 5 JC virus from CSF had rearranged NCCR. Four out of the 5 (80%) had detectable JC
virus DNA in urine 3 of which were archetype and 1 was rearranged NCCR. The median
CD4 was 108.2 cells/ mm³.
These findings suggest a much lower prevalence of JC virus compared to
Europe and North America where seropositivity is about 50%. The study underlies and
further implicates genetic rearrangements of the JC virus being responsible for the
neuropathogenesis of JC virus in immunocompromised individuals especially those with HIV
or AIDS disease.
Description
Master of Science in Medical Microbiology
Keywords
JC virus , Multifocal Leukoencephalopathy