HIV-Associated JC Virus-Granule-Cell Neuronopathy (JCV-GCN) with the Hot-Cross-Bun Sign

Antoine Moulignier, Julie B

Abstract

Progressive multifocal leukoencephalopathy has long been described as the sole feature of JC virus (JCV) infection of the central nervous system. Over the past decade, its spectrum has extended to new forms of encephalopathy, notably affecting neurons. We describe an HIV-infected patient with worsening cerebellar symptoms, progressive cerebellar atrophy and a hot-cross-bun sign attributed to JCV–granule-cell neuronopathy (GCN), and 20 years of follow-up.