Serological evidence of increased susceptibility to varicella-zoster virus reactivation or reinfection in natalizumab-treated patients with multiple sclerosis

Language
en
Document Type
Article
Issue Date
2017-01-31
Issue Year
2015
Authors
Kohlmann, Rebekka
Salmen, Anke
Chan, Andrew
Knabbe, Cornelius
Diekmann, Jürgen
Brockmeyer, Norbert
Skaletz-Rorowski, Adriane
Michalik, Claudia
Gold, Ralf
Überla, Klaus
Editor
Abstract

Background:

Serious adverse drug reactions of disease-modifying drugs in multiple sclerosis (MS) therapy may include enhanced susceptibility to reactivation of neurotropic herpes viruses like varicella-zoster virus (VZV) and the John Cunningham (JC) polyomavirus.

Objective:

Because symptomatic reactivation of these viruses are rare events, we determined the incidence of rises in anti-VZV IgG antibody levels as a potential marker for enhanced susceptibility to subclinical and symptomatic reactivation of neurotropic viruses.

Methods:

Anti-VZV IgG levels were measured in paired serum samples taken 6–8 months apart from natalizumab-treated MS patients, healthy blood donors and human immunodeficiency virus (HIV) infected patients.

Results:

The incidence of significant rises in anti-VZV IgG levels in natalizumab-treated MS patients was 4.26 per 100 person-years, which was significantly higher than in healthy blood donors. Retrospective evaluation of the available medical records of patients with rises of anti-VZV IgG levels did not reveal herpes zoster (i.e. shingles) manifestations.

Conclusions:

The increased incidence of significant rises of anti-VZV IgG levels in natalizumab-treated MS patients might indicate an association of natalizumab treatment of MS with an elevated risk of a subclinical VZV reactivation and/or reinfection events. Whether this is predictive of an increased risk of herpes zoster or even symptomatic reactivation of other neurotropic viruses remains to be determined in larger prospective studies.

Journal Title
Multiple Sclerosis Journal
Volume
21
Issue
14
Citation
Multiple Sclerosis Journal 21.14 (2015): S. 1823-1832. <http://journals.sagepub.com/doi/full/10.1177/1352458515576984>
Zugehörige ORCIDs