Date of Conferral

2-26-2025

Degree

Ph.D.

School

Public Health

Advisor

David Segal

Abstract

JC polyomavirus (JCV) causes progressive multifocal leukoencephalopathy in immunocompromised individuals and has been linked to cancer development. To-date, no information is available about the JCV seroprevalence in the healthy (nondiseased) population or whether this virus is ecologically connected to humans. The aim of this systematic literature review and meta-analysis was to the estimate the overall seroprevalence of JCV in the healthy human population by age, region, and testing method. A meta-analysis conducted on 24 studies revealed a pooled JCV seroprevalence of 60% (95% CI, 55% - 65%) with statistically significant effect size (z = 32.93, p < 0.001). Meta-regression and subgroup analyses with STATA18 showed that age and region had a strong positive predictive value on prevalence (R = .578, R2 = 0.334, F(2,52) = 12.543, p < 0.001) whereas the testing method had no significant effect on prevalence. The theories that grounded this study were the ecological model and the systems theory, which support the study result that JCV appears to be ubiquitous in the human population with JCV being acquired very early in life. The results of the systematic literature review indicated that JCV is transmitted via fecal-oral and respiratory routes within and outside of families. Most infants are infected with JCV by the age of 6 months and JCV seronegativity may not be indicative of a lack of an underlying JCV infection. JCV seropositivity increases with age, which is most probably by viral reactivation due to immune senescence. These findings have positive social change implications with JCV treatment, screening, and vaccine development.

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