JC virus DNA in cerebrospinal fluid samples from Brazilian AIDS patients with focal brain lesions without mass effect - 17/08/11

Doi : 10.1016/j.jinf.2005.02.015

M.C.D.S. Fink ^a, A.C. Penalva de Oliveira ^b, F.A.P. Milagres ^b, J.E. Vidal ^b, A.F. Picerno-Pouza ^b, A. Duarte Neto ^c, C.S. Pannuti ^a,^c,^⁎
^a Laboratório de Virologia (LIM HC-FMUSP), Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Rua Dr Enéas de Carvalho Aguiar, 470, São Paulo, Brazil
^b Instituto de Infectologia Emílio Ribas, Avenida Dr Arnaldo, 165, São Paulo, Brazil
^c Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, Rua Dr Enéas de Carvalho Aguiar, 255, São Paulo, Brazil

Corresponding author. Address: Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Rua Dr Enéas de Carvalho Aguiar, 470, 2° andar, CEP 05403-000 São Paulo, Brazil. Tel.: +55 11 3062 2645; fax: +55 11 3063 2659.

Summary

Objective

To evaluate the presence of JC virus DNA in CSF samples from Brazilian AIDS patients with focal lesions of CNS white matter without mass effect compatible with progressive multifocal leukoencephalopathy (PML).

Methods

CSF samples from AIDS patients with neurological symptoms and a CT scan showing focal lesions of CNS white matter without mass effect suggestive of PML, and from AIDS and non-AIDS patients with non-PML neurological diseases were tested for JC virus DNA by PCR. The primers used to amplify the T antigen region of the JC virus resulted in a 173-bp fragment. The presence of the JC virus was confirmed by digestion of the PCR product using BamH1.

Results

The PCR for JCV DNA was negative in 119/120 non-PML CSF samples (specificity =99.2%). Of 56 CSF samples from AIDS patients with focal lesions of CNS white matter without mass effect, JCV DNA was positive in 48.2% (27/56). In 23/29 (79.3%) JCV DNA-negative cases, other causes for the encephalitic lesions were found. No JCV DNA-positive cases showed other diagnoses.

Conclusions

The prevalence of JCV DNA by PCR in CSF samples from Brazilian AIDS patients with focal brain lesions, without mass effect was 48.2%. In these patients, a negative JCV PCR is highly suggestive of other neurological conditions.

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Keywords : JC virus DNA, Polymerase chain reaction, Cerebrospinal fluid, AIDS, Focal brain lesions