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Journal of NeuroVirology

, Volume 7, Issue 4, pp 318–322 | Cite as

JCV-specific cellular immune response correlates with a favorable clinical outcome in HIV-infected individuals with progressive multifocal leukoencephalopathy

  • Renaud A. Du Pasquier
  • Katherine W. Clark
  • Philip S. Smith
  • Jeffrey T. Joseph
  • John M. Mazullo
  • Umberto De Girolami
  • Norman L. Letvin
  • Igor J. KoralnikEmail author
Immunovirology Report

Abstract

Most immunosuppressed individuals who develop progressive multifocal leukoencephalopathy (PML) have a rapid fatal outcome, whereas some become long-term survivors. We explored the impact of the cellular immune response against JC virus (JCV) on the clinical outcome of 7 HIV+ and 3 HIV−individuals with PML. Of the 4 HIV+/PML survivors, all had detectable cytotoxic T lymphocytes (CTL) specific for JCV T or VP1 proteins compared to none of the 3 HIV+/PML progressors tested. Of the 3 HIV−/PML patients, 1 was recently diagnosed with PML and showed evidence of neurologic improvement without any treatment. This patient had CTL specific for the VP1 protein of JCV. The other 2 HIV−/PML survivors were stable 3–8 years after the diagnosis of PML. They did not have any detectable CTL against JCV. These findings suggest that JCV-specific immune response is associated with favorable outcome in HIV+ individuals with PML. The lack of detectable JCV-specific CTL in 2 HIV−/PML survivors might indicate a burnt-out disease without sufficient antigenic stimulation to maintain the cellular immune response. The detection of JCV-specific CTL in an HIV−patient recently diagnosed with PML, who was showing evidence of neurological improvement without any treatment, indicates that this finding may be used as a favorable prognostic marker of disease evolution in the clinical management of patients with PML. As the quest for an effective treatment of PML continues, JCV-specific cellular immune response deserves further attention because it appears to play a crucial role in the prevention of disease progression.

Keywords

progressive multifocal leukoencephalopathy (PML) human immunodeficiency virus (HIV) acquired immune deficiency syndrome (AIDS) cytotoxic T lymphocytes 

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Copyright information

© Journal of NeuroVirology, Inc. 2001

Authors and Affiliations

  • Renaud A. Du Pasquier
    • 1
    • 2
  • Katherine W. Clark
    • 3
  • Philip S. Smith
    • 4
  • Jeffrey T. Joseph
    • 1
  • John M. Mazullo
    • 5
  • Umberto De Girolami
    • 6
  • Norman L. Letvin
    • 2
  • Igor J. Koralnik
    • 1
    • 2
    Email author
  1. 1.Department of NeurologyBeth Israel Deaconess Medical CenterBostonUSA
  2. 2.Division of Viral Pathogenesis, Department of MedicineBeth Israel Deaconess Medical CenterBostonUSA
  3. 3.St. Francis HospitalPoughkeepsieUSA
  4. 4.St. Luke’s HospitalNewburghUSA
  5. 5.New England Medical CenterBostonUSA
  6. 6.Department of PathologyBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA

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