DETECTION OF JC VIRUS IN 2 AFRICAN CASES OF PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY INCLUDING IDENTIFICATION OF JCV TYPE-3 IN A GAMBIAN AIDS PATIENT

Progressive multifocal leukoencephalopathy (PML) is a fatal demyelinat ing central nervous system (CNS) infection, affecting mainly oligodend rocytes, but also occasional astrocytes, In the USA, Europe and Asia, PML is caused by the human polyomavirus JC virus (JCV) and in autopsy series occurs in about 4-7% of AIDS patients. In Africa, the prevalenc e of PML in AIDS patients is uncertain and the causative agent is unkn own. This study reports immunocytochemical and PCR confirmation of PML in the CNS of an AIDS patient dying in Uganda, East Africa (case 1), In a Gambian patient infected with HIV-2 who died 3 months after onset of AIDS/PML in Germany (case 2), it was possible to confirm the ident ity of the virus by DNA sequencing of the PCR amplified JCV product. T his African genotype of the virus (type 3) showed an unusual re-arrang ement of the regulatory region, and could be distinguished at several sites from East African and African-American JCV strains described pre viously. This study has confirmed that PML is a complication of Africa n AIDS as it is in Europe and the USA, and that JCV type 3 is pathogen ic in African AIDS patients. Furthermore, the finding of an African ge notype of JCV in a patient dying in Germany suggests that in this indi vidual JCV represented a latent infection acquired in Africa.