B has been HIV positive for several years. Recently, B began to experience some disturbing symptoms. B has begun to have problems with vision and motor control. Clinical tests indicate B's immune function is declining. What other viruses besides HIV might be causing B's problems? How might this be verified?
What will be an ideal response?
As immune function declines, latent viral infections can reactivate. The vision problems are consistent with cytomegalovirus reactivation, but the motor control problems suggest another possibility. Reactivation of JC virus can result in viral infection of important support cells of the brain (oligodendrocytes) which will eventually lead to a variety of neurological problems as neurons in the brain die. Both viruses are widespread in the population.
CMV reactivation may be detected using ELISA or DNA probes. Immunoassays may detect JC virions. Treatment for retinal CMV is available. There are currently no treatment options for reactivated JC virus.
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