Viral and Prion Infections Associated with Central Nervous System Syndromes in Brazil

Abstract

Virus-induced infections of the central nervous system (CNS) are among the most serious problems in public health and can be associated with high rates of morbidity and mortality, mainly in low- and middle-income countries, where these manifestations have been neglected. Typically, herpes simplex virus 1 and 2, varicella-zoster, and enterovirus are responsible for a high number of cases in immunocompetent hosts, whereas other herpesviruses (for example, cytomegalovirus) are the most common in immunocompromised individuals. Arboviruses have also been associated with outbreaks with a high burden of neurological disorders, such as the Zika virus epidemic in Brazil. There is a current lack of understanding in Brazil about the most common viruses involved in CNS infections. In this review, we briefly summarize the most recent studies and findings associated with the CNS, in addition to epidemiological data that provide extensive information on the circulation and diversity of the most common neuro-invasive viruses in Brazil. We also highlight important aspects of the prion-associated diseases. This review provides readers with better knowledge of virus-associated CNS infections. A deeper understanding of these infections will support the improvement of the current surveillance strategies to allow the timely monitoring of the emergence/re-emergence of neurotropic viruses.

Herpesvirus and neurological manifestations in patients with severe coronavirus disease

“…The most commonly detected herpesviruses in patients with neurological changes were HHV-6, CMV, and HHV-7. Although a statistically significant association between neurological changes and herpesvirus detection was only observed for HHV-6, CMV was also detected in several patients, and the reactivation of this virus is also associated with neurological changes in immunocompromised patients [ 20 ]. The immunosuppressive condition triggered by SARS-CoV-2 infection may play a role in reactivation herpesvirus, which may cause diffuse encephalitisand myelitis [ 20 ].…”

“…Although a statistically significant association between neurological changes and herpesvirus detection was only observed for HHV-6, CMV was also detected in several patients, and the reactivation of this virus is also associated with neurological changes in immunocompromised patients [ 20 ]. The immunosuppressive condition triggered by SARS-CoV-2 infection may play a role in reactivation herpesvirus, which may cause diffuse encephalitisand myelitis [ 20 ]. In addition, some patients were treated with corticosteroids, and we know that use of corticosteroids can trigger herpesvirus reactivation, studies have demonstrated the association between the use of corticosteroids and reactivation of CMV and HHV-6, which coincidentally also were the most detected herpesviruses in our study population [ 43 ].…”

“…All of the viruses are double-stranded DNA viruses belonging to family Herpesviridae and are capable of establishing latency in their hosts, with the potential for reactivation in immunocompromised patients, which can lead to several complications [ 18 , 19 ]. Neurological disorders have been reported in patients with herpesvirus reactivation [ 20 ]. HHV-1 is considered the main cause of viral encephalitis, which is associated with epileptic seizures in most cases [ 21 ].…”

Analysis of Coxsackievirus B5 Infections in the Central Nervous System in Brazil: Insights into Molecular Epidemiology and Genetic Diversity

“…Numerous studies about CNS infection have been conducted in recent years, and non-polio enteroviruses have mostly been reported as an important causative agent associated with sporadic cases and outbreaks [ 7 , 8 , 36 , 37 , 38 ]. In this context, we evaluated the epidemiological and molecular characteristics of CVB5 isolated from CNS infections between 2005 and 2018 in Brazil.…”

Doenças priônicas neurodegenerativas humanas: o que sabemos e sua epidemiologia no Brasil

“…Apesar de ser extremamente raro no Brasil, no ano de 2017 foram relatados sete casos de GSS em duas famílias no país com mutação P102L, sendo quatro associadas a 129 M/V, dois a 129 M/M e um sem dado disponível para o códon 129. Estes indivíduos tinham idades entre 25 a 66 anos e tiveram um período de duração da doença variando entre 8 meses e 15 anos (Souza et al, 2021). Recentemente um caso de DCJ variante Heidenhain (sDCJ) foi relatado em uma mulher de 54 anos sendo este MM2C e cursando com alucinações visuais e progressiva e rápida demência (Mendonça et al, 2020).…”