Herpes simplex virus infections of the central nervous system in human immunodeficiency virus-infected patients: Clinical management by polymerase chain reaction assay of cerebrospinal fluid

Paola Cinque, Luca Vago, Roberta Marenzi, Barbara Giudici, Thomas Weber, Rita Corradini, Daniela Ceresa, Adriano Lazzarin, Annika Linde

Research output: Contribution to journalArticlepeer-review

Abstract

A duplex polymerase chain reaction (PCR) assay for DNA from herpes simplex virus types 1 (HSV-1) and 2 (HSV-2) was applied to cerebrospinal fluid (CSF) from 918 human immunodeficiency virus (HIV)-infected patients with neurological symptoms. HSV-1 or HSV-2 (HSV-1/2) DNA was found in 19 patients (2%). For the 258 patients for whom a diagnosis was confirmed at autopsy, the sensitivity and specificity of PCR analysis for the diagnosis of HSV-1/2 encephalitis were 100% and 99.6%, respectively. Three patients with CD4+ cell counts of ≤170/μL had HSV-1 central nervous system (CNS) infections (two) or HSV-2 meningitis (one). Sixteen patients with CD4+ cell counts of <40/μL had HSV-1 CNS infections (two) or mixed HSV-1/2 and cytomegalovirus encephalitis (14). The response to antiviral treatment, which was assessed clinically and by CSF PCR analysis, was variable in the patients with the highest CD4+ cell counts and poor in those with more severe immunosuppression. CSF PCR analysis is of value for the diagnosis and follow- up of treatment of HSV-1/2 CNS infections in HIV-infected patients.

Original languageEnglish
Pages (from-to)303-309
Number of pages7
JournalClinical Infectious Diseases
Volume27
Issue number2
Publication statusPublished - 1998

ASJC Scopus subject areas

  • Immunology

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