Neurological complications of varicella-zoster virus infection in adults with human immunodeficiency virus infection
| Autor: | Eric Caumes, J Livartowski, F Lionnet, Pierre Lebon, O Picard, A De La Blanchardiere, D. Sicard, D. Salmon-Ceron, F. Rozenberg, J. Coste |
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| Rok vydání: | 2000 |
| Předmět: |
Microbiology (medical)
Adult Male medicine.medical_specialty Pathology Herpesvirus 3 Human Opportunistic infection viruses Myelitis HIV Infections medicine.disease_cause Gastroenterology Herpes Zoster Polymerase Chain Reaction Central Nervous System Infections Internal medicine medicine Humans CSF albumin Retrospective Studies General Immunology and Microbiology business.industry Varicella zoster virus virus diseases General Medicine Middle Aged medicine.disease Prognosis Magnetic Resonance Imaging CD4 Lymphocyte Count Infectious Diseases Disease Progression Female Acute retinal necrosis business Tomography X-Ray Computed Meningitis Encephalitis Shingles |
| Zdroj: | Scandinavian journal of infectious diseases. 32(3) |
| ISSN: | 0036-5548 |
| Popis: | This multicentre retrospective study describes the clinical features and prognostic significance of Varicella-zoster virus (VZV)-associated neurological complications. The study was performed in patients with human immunodeficiency virus (HIV) infection, hospitalized for VZV neurological complications, confirmed in every case by positive VZV polymerase chain reaction (PCR) in cerebrospinal fluid (CSF). Between 1990 and 1995, 34 HIV-infected patients were included in the study. At diagnosis, 59% had AIDS, with a median CD4 count of 11 x 10(9)/l. A past history of zoster was noted in 35% of cases. A concomitant herpes zoster rash and/or acute retinal necrosis were noted in 71% and 12% of patients, respectively. The predominant neurological manifestations were encephalitis (13), myelitis (8), radiculitis (7) and meningitis (6). The mean CSF white blood cell count was 126/mm3 and the mean CSF protein concentration was 2.3 g/l. Interferon-alpha level was increased in 36% of patients. VZV was isolated from CSF cultures in 2/6 cases. Magnetic resonance imaging was abnormal, demonstrating encephalitis lesions. After intravenous antiviral therapy, complete recovery was obtained in 18 cases (53%), serious sequelae were observed in 10 cases (29%) and 6 patients died (18%). Severe symptoms and a low CD4 cell count appeared to be associated with death or sequelae. In conclusion, VZV should be considered as a possible cause of encephalitis, myelitis, radiculitis or meningitis in HIV-infected patients, especially in patients with a history of or concomitant herpes zoster or acute retinal necrosis. VZV-PCR in the CSF may allow rapid diagnosis and early specific antiviral treatment. |
| Databáze: | OpenAIRE |
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