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Journal of Clinical Microbiology, March 1999, p. 724-728, Vol. 37, No. 3
Servicio de Microbiología y
Enfermedades Infecciosas-HIV, Hospital General Universitario
"Gregorio Marañón," 28007 Madrid, Spain
Received 8 July 1998/Returned for modification 20 August
1998/Accepted 13 October 1998
JC polyomavirus (JCV) is the causative agent of progressive
multifocal leukoencephalopathy (PML), a central nervous system infection that mainly affects AIDS patients. The extensive application of highly active antiretroviral therapy (HAART) is leading to the
appearance of "long-term" survival PML patients. A reliable and
feasible qualitative-quantitative test for both the detection of JCV
and follow-up of its viral burden in this emerging group of patients is
clearly required. With this aim, a dual qualitative-quantitative nested
PCR is presented in this study for the analysis of JCV DNA in
cerebrospinal fluid (CSF). Two newly designed internal controls, one
competitive and the other noncompetitive, have been constructed to
adapt this PCR to either measure the JCV burden or to allow a highly
confident determination of JCV presence or clearance. The analytical
sensitivity of the technique allows the detection of 0.01 fg (three
genomes) of JCV DNA. Its qualitative application has been evaluated by
analyzing single CSF samples from a group of 17 patients with PML and a
control group of 20 patients with diverse neurological conditions other
than PML, yielding sensitivity and specificity values of 100 and 90%,
respectively. The quantitative application has been evaluated in vitro
in blind tests with samples including serial dilutions of JCV, and in
all cases the samples were successfully ordered considering the JCV titer. The dual quantitative-qualitative application offered by this
nested PCR may provide an answer to the new requirements for evaluating
and finely monitoring PML in AIDS patients receiving HAART.
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Dual Qualitative-Quantitative Nested PCR for Detection of JC
Virus in Cerebrospinal Fluid: High Potential for Evaluation
and Monitoring of Progressive Multifocal Leukoencephalopathy
in AIDS Patients Receiving Highly Active Antiretroviral
Therapy
*
Corresponding author. Mailing address: Servicio de
Microbiología y Enfermedades Infecciosas-HIV, Hospital General
Universitario "Gregorio Marañón," C/Dr. Esquerdo, 46, 28007 Madrid, Spain. Phone: (34-91) 586-87-93. Fax: (34-91) 504-49-06. E-mail: dgviedma{at}microb.net.
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