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Effective use of JC virus PCR for diagnosis of progressive multifocal leukoencephalopathy

Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA

Correspondence
Qinfang Qian
qqian{at}bidmc.harvard.edu

Received July 11, 2008
Accepted October 5, 2008

In a retrospective review of data from 168 patients with suspected progressive multifocal leukoencephalopathy (PML) between 1996 and 2006, JC virus (JCV) PCR on cerebrospinal fluid (CSF) samples was positive only in human immunodeficiency virus (HIV)-infected patients with low CD4 cell counts and in severely immunocompromised patients with radiographic lesions consistent with PML or infectious processes generally. Of note, one HIV patient with a very low CD4 cell count had a positive JCV PCR despite a normal magnetic resonance imaging exam. We concluded that JCV PCR testing on CSF specimens should therefore be targeted to these high-risk patients.

Abbreviations: CSF, cerebrospinal fluid; HAART, highly active antiretroviral therapy; JCV, JC virus; MRI, magnetic resonance imaging; PML, progressive multifocal leukoencephalopathy.