JC Virus Infection of the Brain

Since its initial description, there have been significant changes in the epidemiology, pathogenesis, and clinical and imaging manifestations of JCV infection of brain. The most common clinical manifestation is PML. Other recently described CNS manifestations are JCE, JCVGCN, and JCM. Although AIDS...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2010-10, Vol.31 (9), p.1564-1576
Main Authors: BAG, A. K, CURE, J. K, CHAPMAN, P. R, ROBERSON, G. H, SHAH, R
Format: Article
Language:English
Subjects:
Biological and medical sciences
Brain - immunology
Brain - pathology
Fundamental and applied biological sciences. Psychology
Human immunodeficiency virus
Humans
Investigative techniques, diagnostic techniques (general aspects)
JC virus
Leukoencephalopathy, Progressive Multifocal - diagnosis
Leukoencephalopathy, Progressive Multifocal - immunology
Magnetic Resonance Imaging - methods
Magnetic Resonance Spectroscopy - methods
Medical sciences
Nervous system
Personality. Affectivity
Psychology. Psychoanalysis. Psychiatry
Psychology. Psychophysiology
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Review
Sexuality. Sexual behavior
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Summary:Since its initial description, there have been significant changes in the epidemiology, pathogenesis, and clinical and imaging manifestations of JCV infection of brain. The most common clinical manifestation is PML. Other recently described CNS manifestations are JCE, JCVGCN, and JCM. Although AIDS is the most common predisposing factor for JCV reactivation, there is increasing incidence of brain manifestations of JCV reactivation in non-HIV settings, including different rheumatologic, hematologic, and oncologic conditions; monoclonal antibody therapy; transplant recipients; primary immunodeficiency syndromes; and even in patients without any recognizable immune deficiency. IRIS may develop secondary to restoration of immunity in HIV-positive patients with PML receiving antiretroviral therapy. This is of profound clinical significance and needs to be diagnosed promptly. Imaging plays a crucial role in the diagnosis of the disease, monitoring of treatment response, identifying disease progression, and predicting prognosis. In this article, current understanding of the epidemiology, pathogenesis, clinical presentations, and all aspects of imaging of JCV infection of the brain have been comprehensively reviewed.
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A2035