J Clin Neurol.  2019 Oct;15(4):454-460. 10.3988/jcn.2019.15.4.454.

High Seroprevalence and Index of Anti-John-Cunningham Virus Antibodies in Korean Patients with Multiple Sclerosis

• Kim SH
• Kim Y
• Jung JY
• Park NY
• Jang H
• Hyun JW
• Kim HJ

• KMID: 2467753
• DOI: http://doi.org/10.3988/jcn.2019.15.4.454

Abstract

BACKGROUND AND PURPOSE
The anti-John-Cunningham virus (JCV)-antibody serostatus and index are used in the risk stratification of progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS) patients treated with natalizumab. However, little information on these parameters is available for Asian countries. The purpose of this study was to determine the rate of seropositivity, index, and longitudinal index evolution in Korean patients with MS.
METHODS
The antibody seroprevalence was analyzed in 355 samples from 187 patients with clinically isolated syndrome or MS using a second-generation, two-step, enzyme-linked immunosorbent assay. A 4-year longitudinal evaluation was applied to 66 patients.
RESULTS
The overall antibody seroprevalence was 80% (n=149). Among antibody-positive patients, the index had a median value of 3.27 (interquartile range, 1.52-4.18), with 77% (n=114) and 56% (n=83) of patients having indices >1.5 and >3.0, respectively. The serostatus of 59 (89%) of the 66 patients did not change during the longitudinal analysis, while 3 (6%) of the 53 patients who were initially seropositive reverted to seronegativity, and 2 (15%) of the 13 patients who were initially seronegative converted to seropositivity. All patients with a baseline index >0.9 maintained seropositivity, and 92% of patients with a baseline index >1.5 maintained this index over 4 years. No patients developed PML (median disease duration, 8 years).
CONCLUSIONS
The seroprevalence and index of anti-JCV antibodies in Korean patients with MS may be higher than those in Western countries.

Keyword

John Cunningham virus; antibodies; index; progressive multifocal leukoencephalopathy; Asia

MeSH Terms

Antibodies*
Asia
Asian Continental Ancestry Group
Enzyme-Linked Immunosorbent Assay
Humans
JC Virus
Leukoencephalopathy, Progressive Multifocal
Multiple Sclerosis*
Natalizumab
Seroepidemiologic Studies*
Antibodies
Natalizumab

Figure

• 

  Fig. 1 Anti-JCV antibody index level in patients with multiple sclerosis. A: Anti-JCV-antibody index at baseline in seropositive patients. Dashed line and horizontal bars indicate the median and interquartile-range values, respectively. B: Anti-JCV-antibody index of seropositive patients with multiple sclerosis. The indices of anti-JCV-antibody-positive patients did not increase with age. JCV: John-Cunningham virus.

• 

  Fig. 2 Serial assessment of anti-JCV-antibody indices of patients who were seropositive at baseline (two to seven JCV serology assessments were performed in each patient). A: Patients with anti-JCV indices >1.5. B: Patients with anti-JCV indices ≤1.5. Horizontal dashed lines indicate indices of 0.2, 0.4, and 1.5. JCV: John-Cunningham virus.

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