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Journal of Clinical Microbiology, March 1999, p. 724-728, Vol. 37, No. 3
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

Darío García de Viedma,* Roberto Alonso, Pilar Miralles, Juan Berenguer, Marta Rodriguez-Créixems, and Emilio Bouza

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.


* 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.


Journal of Clinical Microbiology, March 1999, p. 724-728, Vol. 37, No. 3
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.



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