Abstract
Objective: To determine the impact of therapeutic infusion of IV immunoglobulin (IVIg) on John Cunningham virus antibody (JCV Ab) serostatus and level in serum.
Methods: We carried out a retrospective analysis of serum levels of JCV Ab among STRATIFY-2 trial enrollees from 2 multiple sclerosis centers who were exposed to IVIg during the trial. For the subset of eligible patients, we estimated mean linear trends while on IVIg and after stopping IVIg with a linear mixed-effects model.
Results: The JCV Ab seropositivity rate in the group of patients that was recently exposed to IVIg was 100%, which is significantly higher than in the IVIg-naive population (58%, p < 0.001). The seropositivity rate in the patient group with remote IVIg exposure was similar to that in the IVIg-naive population (67%, p = 0.68, Fisher exact test). The slope of the linear trend line after stopping IVIg decreased significantly by −0.310 units per 100 days (95% confidence interval, −0.611 to −0.008; p = 0.04).
Conclusions: Recent IVIg exposure is invariably associated with JCV Ab seropositivity. After stopping IVIg, JCV Ab levels tend to decrease with time, and seroreversion to innately Ab-negative status can occur.
Glossary
- Ab=
- antibody;
- CI=
- confidence interval;
- IRIS=
- immune reconstitution inflammatory syndrome;
- IVIg=
- IV immunoglobulin;
- JCV=
- John Cunningham virus;
- mAb=
- monoclonal antibody;
- MS=
- multiple sclerosis;
- nOD=
- normalized optical density;
- PML=
- progressive multifocal leukoencephalopathy
Footnotes
Go to Neurology.org/nn for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article. The Article Processing Charge was paid by Biogen Idec.
- Received April 30, 2014.
- Accepted in final form August 13, 2014.
- © 2014 American Academy of Neurology
This is an open access article distributed under the terms of the Creative Commons Attribution-Noncommercial No Derivative 3.0 License, which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially.
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