{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:46:07Z","timestamp":1790397967557,"version":"4.1.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2017,5,16]],"date-time":"2017-05-16T00:00:00Z","timestamp":1494892800000},"content-version":"vor","delay-in-days":135,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Progressive multifocal leukoencephalopathy (PML) is a deadly demyelinating disease due to central nervous system replication of the human polyomavirus JC virus (JCV) in immunosuppressed patients. The only effective therapeutic approach is to restore anti-JCV T-cell responses. In this study, we describe a case of rapidly fatal PML with JCV T-cell anergy in a renal transplant patient treated with CTLA4-Ig (belatacept, a CD28-B7 costimulation blocker and T-cell anergy inducer). T-cell anergy could not be reversed despite several therapeutic approaches. Progressive multifocal leukoencephalopathy secondary to biotherapy-induced T-cell anergy may thus represent a subset of PML with major resistance to anti-JCV immune recovery.<\/jats:p>","DOI":"10.1093\/ofid\/ofx100","type":"journal-article","created":{"date-parts":[[2017,5,16]],"date-time":"2017-05-16T07:11:09Z","timestamp":1494918669000},"source":"Crossref","is-referenced-by-count":17,"title":["Refractory T-Cell Anergy and Rapidly Fatal Progressive Multifocal Leukoencephalopathy After Prolonged CTLA4 Therapy"],"prefix":"10.1093","volume":"4","author":[{"given":"Manon","family":"Dekeyser","sequence":"first","affiliation":[{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) U1184, Immunology of Viral Infection and Auto-immune Diseases, Normal and Pathological T Memory, Facult\u00e9 de M\u00e9decine Paris-Sud, le Kremlin-Bic\u00eatre"},{"name":"Institut Francilien de Techerche en N\u00e9phrologie et Transplantation, Department of Nephrology and Transplantation, H\u00f4pitaux Universitaires Paris-Sud, France; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Ghislaine","family":"de Go\u00ebr de Herve","sequence":"additional","affiliation":[{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) U1184, Immunology of Viral Infection and Auto-immune Diseases, Normal and Pathological T Memory, Facult\u00e9 de M\u00e9decine Paris-Sud, le Kremlin-Bic\u00eatre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Houria","family":"Hendel-Chavez","sequence":"additional","affiliation":[{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) U1184, Immunology of Viral Infection and Auto-immune Diseases, Normal and Pathological T Memory, Facult\u00e9 de M\u00e9decine Paris-Sud, le Kremlin-Bic\u00eatre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9line","family":"Labeyrie","sequence":"additional","affiliation":[{"name":"Department of Neurology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Neurology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gha\u00efdaa Adebs","family":"Nasser","sequence":"additional","affiliation":[{"name":"Department of Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Gasnault","sequence":"additional","affiliation":[{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) U1184, Immunology of Viral Infection and Auto-immune Diseases, Normal and Pathological T Memory, Facult\u00e9 de M\u00e9decine Paris-Sud, le Kremlin-Bic\u00eatre"},{"name":"Department of Internal Medicine, Unit of Neuro-Virological Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Durrbach","sequence":"additional","affiliation":[{"name":"Institut Francilien de Techerche en N\u00e9phrologie et Transplantation, Department of Nephrology and Transplantation, H\u00f4pitaux Universitaires Paris-Sud, France; and"},{"name":"INSERM UMR 1197, Interactions between stem cells and their niches in physiology, tumors and tissue repair - Stem cells, Transplantation, Immunoregulation, H\u00f4pitaux Universitaires Paris-Sud, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yassine","family":"Taoufik","sequence":"additional","affiliation":[{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) U1184, Immunology of Viral Infection and Auto-immune Diseases, Normal and Pathological T Memory, Facult\u00e9 de M\u00e9decine Paris-Sud, le 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