Epidemiol Health.  2018;40:e2018001. 10.4178/epih.e2018001.

Systematic review of the published data on the worldwide prevalence of John Cunningham virus in patients with multiple sclerosis and neuromyelitis optica

• Paz SP
• Branco L
• Pereira MA
• Spessotto
• Fragoso YD

• KMID: 2438457
• DOI: http://doi.org/10.4178/epih.e2018001

Abstract

OBJECTIVES
John Cunningham virus (JCV) is a polyoma virus that infects humans, mainly in childhood or adolescence, and presents no symptomatic manifestations. JCV can cause progressive multifocal leukoencephalopathy (PML) in immunosuppressed individuals, including those undergoing treatment for multiple sclerosis (MS) and neuromyelitis optica (NMO). PML is a severe and potentially fatal disease of the brain. The prevalence of JCV antibodies in human serum has been reported to be between 50.0 and 90.0%. The aim of the present study was to review worldwide data on populations of patients with MS and NMO in order to establish the rates of JCV seropositivity in these individuals.
METHODS
The present review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and used the following search terms: "JCV" OR "JC virus" AND "multiple sclerosis" OR "MS" OR "NMO" OR "neuromyelitis optica" AND "prevalence." These terms were searched for both in smaller and in larger clusters of words. The databases searched included PubMed, MEDLINE, SciELO, LILACS, Google Scholar, and Embase.
RESULTS
After the initial selection, 18 papers were included in the review. These articles reported the prevalence of JCV antibodies in the serum of patients with MS or NMO living in 26 countries. The systematic review identified data on 29,319 patients with MS/NMO and found that 57.1% of them (16,730 individuals) were seropositive for the anti-JCV antibody (range, 40.0 to 69.0%).
CONCLUSIONS
The median worldwide prevalence of JCV among adults with MS or NMO was found to be 57.1%.

Keyword

JC virus; Multiple sclerosis; Neuromyelitis optica; Progressive multifocal leukoencephalopathy; Natalizumab

MeSH Terms

Adolescent
Adult
Antibodies
Brain
Humans
JC Virus*
Leukoencephalopathy, Progressive Multifocal
Multiple Sclerosis*
Natalizumab
Neuromyelitis Optica*
Polyomavirus
Prevalence*
Antibodies
Natalizumab