Characterizing Epstein-Barr virus infection of the central nervous system in Zambian adults living with HIV.

Autor: Musukuma-Chifulo K; Department of Biomedical Sciences, School of Health Sciences, The University of Zambia, Lusaka, Zambia. kalomusukuma@gmail.com.; Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia. kalomusukuma@gmail.com., Ghebremichael M; Harvard Medical School and Ragon Institute of Mass General, MIT and Harvard, Boston, MA, USA., Chilyabanyama ON; Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia., Bates M; HerpeZ, University Teaching Hospital, Lusaka, Zambia.; School of Life & Environmental Sciences, University of Lincoln, Lincoln, UK., Munsaka S; Department of Biomedical Sciences, School of Health Sciences, The University of Zambia, Lusaka, Zambia., Simuyandi M; Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia., Chisenga C; Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia., Tembo J; HerpeZ, University Teaching Hospital, Lusaka, Zambia., Sinkala E; Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia., Koralnik IJ; Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA., Dang X; Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA., Chilengi R; Zambia National Public Health Institute, Ministry of Health, 10101, Lusaka, Zambia., Siddiqi OK; Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.; Global Neurology Program, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Center for Vaccines and Virology Research, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Journal of neurovirology [J Neurovirol] 2023 Dec; Vol. 29 (6), pp. 706-712. Date of Electronic Publication: 2023 Oct 30.
DOI: 10.1007/s13365-023-01178-4
Abstrakt: The significance of Epstein-Barr virus (EBV) detection in the cerebrospinal spinal fluid (CSF) in people living with HIV (PLWH) is not entirely understood. The detection of EBV DNA may represent active central nervous system (CNS) infection, reactivation in the setting of another CNS pathogen or due to impaired immunity, or detection of quiescent virus. We screened 470 adult PLWH in Zambia with neurological symptoms for the presence of EBV DNA in the CSF. We performed quantitative EBV PCR on the CSF and blood. We then performed quantitative EBV DNA PCR on the blood of controls with documented HIV viral suppression without CNS symptoms. The prevalence of EBV DNA in the CSF of patients with CNS symptoms was 28.9% (136/470). EBV DNA positivity was associated with younger age, shorter duration of HIV diagnosis, lower CSF glucose levels, higher CSF protein and white blood cell levels, and a positive CSF Mycobacterium tuberculosis result. The median EBV DNA load was 8000 cps/mL in both the CSF and blood with a range of 2000-2,753,000 cps/mL in the CSF and 1000 to 1,871,000 cps/mL in the blood. Molecular screening of CSF for other possible causes of infection identified Mycobacterium tuberculosis in 30.1% and cytomegalovirus (CMV) in 10.5% of samples. EBV DNA load in the blood and CSF was not associated with mortality. Our results suggest that even though EBV DNA was commonly detected in the CSF of our population, it appears to have limited clinical significance regardless of EBV DNA load.
(© 2023. The Author(s) under exclusive licence to The Journal of NeuroVirology, Inc.)
Databáze: MEDLINE
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