Frequency and Phenotype of JC Virus-Specific CD8+T Lymphocytes in the Peripheral Blood of Patients with Progressive Multifocal Leukoencephalopathy

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Abstract
JC virus (JCV)-specific CD8+cytotoxic T lymphocytes (CTL) are associated with a favorable outcome in patients with progressive multifocal leukoencephalopathy (PML) and cross-recognize the polyomavirus BK virus (BKV). We sought to determine the frequency and phenotype in fresh blood of CD8+T cells specific for two A*0201-restricted JCV epitopes, VP1p36and VP1p100, and assess their impact on JC and BK viremia and viruria in 15 healthy subjects, eight human immunodeficiency virus-positive (HIV+) individuals, and nine HIV+patients with PML (HIV+PML patients) classified as survivors. After magnetic preenrichment of CD8+T cells, epitope-specific cells ranged from 0.001% to 0.22% by tetramer staining, with no significant difference among the three study groups. By use of seven-color flow cytometry, there was no predominant differentiation phenotype subset among JCV-specific CD8+T cells in healthy individuals, HIV+subjects, or HIV+PML patients. However, in one HIV+PML patient studied in the acute phase, there was a majority of activated effector memory cells. BKV DNA was undetectable in all blood samples by quantitative PCR, while a low JC viral load was found in the blood of only one HIV+and two HIV+PML patients. JCV and BKV DNA were detected in 33.3% and 13.3% of all urine samples, respectively, independent of the presence of JCV-specific CTL. The detection of JCV DNA in the urine was associated with the presence of a JCV VP1p100CTL response. Immunotherapies aiming at increasing the cellular immune response against JCV may be valuable in the treatment of HIV+individuals with PML.