Real-time PCR detection of Human Herpesvirus 1-5 in patients lacking clinical signs of a viral CNS infection

Abstract

BackgroundInfections of the central nervous system (CNS) with herpes- or enterovirus can be self-limiting and benign, but occasionally result in severe and fatal disease. The polymerase chain reaction (PCR) has revolutionized the diagnostics of viral pathogens, and by multiple displacement amplification (MDA) prior to real-time PCR the sensitivity might be further enhanced. The aim of this study was to investigate if herpes- or enterovirus can be detected in cerebrospinal fluid (CSF) from patients without symptoms.MethodsCerebrospinal fluid (CSF) samples from 373 patients lacking typical symptoms of viral CNS infection were analysed by real-time PCR targeting herpesviruses or enteroviruses with or without prior MDA.ResultsIn total, virus was detected in 17 patients (4%). Epstein-Barr virus (EBV) was most commonly detected, in general from patients with other conditions (e.g. infections, cerebral hemorrhage). MDA satisfactorily amplified viral DNA in the absence of human nucleic acids, but showed poor amplification capacity for viral DNA in CSF samples, and did not increase the sensitivity for herpes virus-detection with our methodology.ConclusionsViral pathogens are rarely detected in CSF from patients without signs of CNS infection, supporting the view that real-time PCR is a highly specific method to detect symptomatic CNS-infection caused by these viruses. However, EBV may be subclinically reactivated due to other pathological conditions in the CNS.

Role of Viral Agents in Childhood Central Nervous System Infections

“…29 In many other studies investigating viral agents in CNS infections, viral coinfections have been detected. 16,17,20,30 More work is needed to assess the clinical relevance of multiple agent associations. Although viral infections of the CNS are not rare, their incidence is not clearly defined.…”

“…9,10 Nonpolio EVs account for 80 to 95% of aseptic meningitis cases. Among these, the most common types are coxsackievirus B2, B5, echovirus type 4, 6,9,11,16,30, and EV type 70, 71. Enterovirus infections usually increase during the summer, but their incidence may be high in tropical regions throughout the year.…”

Meningoencefalitis por Herpes simplex virus 1 y Streptococcus pneumoniae en Pediatría. Reporte de caso

“…La respuesta inmune a una meningitis bacteriana aguda puede producir parálisis inmunológica llevando a que un virus latente se reactive 10 . La identificación adicional de Herpes tipo 1 y 2 en el LCR, indica infección del SNC activa 11 .…”

Сучасні Підходи До діагностики Герпесвірусних Нейроінфекцій (Науковий Огляд)

“…Слід враховувати, що в пацієнтів із Х-зчепленими лімфопроліферативними синдромами рутинні серологічні тести до EBV є хибнонегативними [64]. Також необхідно пам'ятати, що при EBV-нейроінфекції відзначається поліклональна активація В-лімфоцитів, що може зумовити хибнопозитивні результати серологічної діагностики інших вірусних інфекцій, зокрема корової [61].…”