JC-VIRUS DETECTION IN THE CEREBROSPINAL-FLUID OF AIDS PATIENTS WITH PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY AND MONITORING OF THE ANTIVIRAL TREATMENT BY A PCR METHOD

Twenty-four cerebrospinal fluid (CSF) samples from 19 AIDS patients wi th neurological signs were analysed by the polymerase chain reaction ( PCR) for the presence of JC virus (JCV). Eleven of the 19 patients tes ted presented with progressive multifocal leucoencephalopathy (PML). T wo specific JCV target sequences were used for the PCR analysis: a seq uence specific for the T antigen genes from both BK virus (BKV) and JC V (PCR1) and a sequence specific for the large T antigen gene from JCV (PCR2). The JCV genome was detected in 10 of 11 patients with PML by the PCR1 method and in all 11 patients by the PCR2 method, With sample s from the eight patients without PML, one positive result was obtaine d with the PCR1 method and this sample and another gave positive resul ts with PCR2. Multiple CSF samples were collected fi om three patients with PML at different times, including after intrathecal cytarabine t reatment, and were tested by the PCR2 method for the presence of the J CV genome, The PCR result became negative for two of the three patient s during the cytarabine treatment, However, the absence of a PCR signa l was not associated with clinical improvement in these patients, The PCR method is useful for the detection of JCV in CSF samples and in th e diagnosis of PML. However, the application of PCR for monitoring the effect of treatment remains to be established.