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AIDS-associated progressive multifocal leukoencephalopathy (PML)

Comparison to non-AIDS PML with in situ hybridization and immunohistochemistry

Department of Neurology, Mayo Clinic (Dr. Aksamit), Rochester, MN; Henry M. Jackson Foundation of the Uniformed Services Health Science Center (Dr. Gendelman), Rockville, MD; the Department of Pathology, George Washington University Medical Center (Dr. Orenstein), and the Armed Forces Institute of Pathology (Dr. Pezeshkpour), Washington, DC.

We studied brain sections from 10 patients with the acquired immunodeficiency syndrome (AIDS) and progressive multifocal leukoencephalopathy (PML) by in situ hybridization with a biotin-labeled JC virus (JCV) DNA probe and by immunohistochemistry using antibody against the JCV capsid antigen. We compared the results with brain sections studied in the same fashion from 10 PML patients without AIDS. The pathology of JCV infection in AIDS was similar to non-AIDS PML except for minor differences in degree. AIDS-associated pathologic material showed a greater tendency toward necrosis and a higher density of JCV-infected cells. Replication of JCV was restricted to glial cells in all tissue studied. Bizarre astrocytes were less frequent in the AIDS patients, and perivascular inflammatory cells were more frequent. We could not demonstrate JCV in macrophages or microglial cells known to harbor HIV infection. In situ hyridization with nonradioactive probes serves as a useful technique for the confirmation of PML in AIDS.

Address correspondence and reprint requests to Dr. Allen J. Aksamit, Department of Neurology, Mayo Clinic, Rochester, MN 55905.

H.E. Gendelman is a Carter-Wallace fellow of Johns Hopkins University School of Public Health and Hygiene.

Received June 15, 1989. Accepted for publication in final form December 1, 1989.

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