Polymerase chain reaction on cerebrospinal fluid for diagnosis of virus-associated opportunistic diseases of the central nervous system in HIV-infected patients

Paola Cinque, Luca Vago, Helena Dahl, Maria Brytting, Maria Rosa Terreni, Carla Fornara, Sara Racca, Antonella Castagna, Antonella D Arminio Monforte, Britta Wahren, Adriano Lazzarin, Annika Linde

Research output: Contribution to journalArticle

Abstract

Objective: To assess the diagnostic reliability of polymerase chain reaction (PCR) on cerebrospinal fluid (CSF) for virus-associated opportunistic diseases of the central nervous system (CNS) in HIV-infected patients. Design: CSF samples from 500 patients with HIV infection and CNS symptoms were examined by PCR. In 219 patients the PCR results were compared with CNS histological findings. Methods: Nested PCR for detection of herpes simplex virus (HSV) type 1 or 2, varicella tester virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), and JC virus (JCV) DNA. Histopathological examination of CNS tissue obtained at autopsy or on brain biopsy. Results: DNA of one or more viruses was found in CSF in 181 out of 500 patients (36%; HSV-1 2%, HSV-2 1%, VZV 3%, CMV 16%, EBV 12%, HHV-6 2%, and JCV 9%). Among the 219 patients with histological CNS examination, HSV-1 or 2 was detected in CSF in all six patients (100%) with HSV infection of the CNS, CMV in 37 out of 45 (82%) with CMV infection of the CNS, EBV in 35 out of 36 (97%) with primary CNS lymphoma, JCV in 28 out of 39 (72%) with progressive multifocal leukoencephalopathy. Furthermore, HSV-1 was found in one, VZV in four, CMV in three, EBV in three, HHV-6 in seven, and JCV in one patient without histological evidence of the corresponding CNS disease. Conclusions: CSF PCR has great relevance for diagnosis of virus-related opportunistic CNS diseases in HIV-infected patients as demonstrated by its high sensitivity, specificity, and the frequency of positive findings.

Original languageEnglish
Pages (from-to)951-958
Number of pages8
JournalAIDS (London, England)
Volume10
Issue number9
Publication statusPublished - 1996

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Central Nervous System Diseases
Cerebrospinal Fluid
Human Herpesvirus 2
HIV
JC Virus
Central Nervous System
Human Herpesvirus 1
Viruses
Polymerase Chain Reaction
Human Herpesvirus 6
Cytomegalovirus
Human Herpesvirus 4
Progressive Multifocal Leukoencephalopathy
Nerve Tissue
Chickenpox
DNA
Cytomegalovirus Infections
Virus Diseases
Simplexvirus
HIV Infections

Keywords

  • Central nervous system
  • Cerebrospinal fluid
  • Cytomegalovirus
  • Epstein-Barr virus
  • Herpes simplex virus
  • HIV
  • Human herpesvirus-6
  • JC virus
  • Polymerase chain reaction
  • Varicella zoster virus

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Polymerase chain reaction on cerebrospinal fluid for diagnosis of virus-associated opportunistic diseases of the central nervous system in HIV-infected patients. / Cinque, Paola; Vago, Luca; Dahl, Helena; Brytting, Maria; Terreni, Maria Rosa; Fornara, Carla; Racca, Sara; Castagna, Antonella; Monforte, Antonella D Arminio; Wahren, Britta; Lazzarin, Adriano; Linde, Annika.

In: AIDS (London, England), Vol. 10, No. 9, 1996, p. 951-958.

Research output: Contribution to journalArticle

Cinque, P, Vago, L, Dahl, H, Brytting, M, Terreni, MR, Fornara, C, Racca, S, Castagna, A, Monforte, ADA, Wahren, B, Lazzarin, A & Linde, A 1996, 'Polymerase chain reaction on cerebrospinal fluid for diagnosis of virus-associated opportunistic diseases of the central nervous system in HIV-infected patients', AIDS (London, England), vol. 10, no. 9, pp. 951-958.
Cinque, Paola ; Vago, Luca ; Dahl, Helena ; Brytting, Maria ; Terreni, Maria Rosa ; Fornara, Carla ; Racca, Sara ; Castagna, Antonella ; Monforte, Antonella D Arminio ; Wahren, Britta ; Lazzarin, Adriano ; Linde, Annika. / Polymerase chain reaction on cerebrospinal fluid for diagnosis of virus-associated opportunistic diseases of the central nervous system in HIV-infected patients. In: AIDS (London, England). 1996 ; Vol. 10, No. 9. pp. 951-958.
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abstract = "Objective: To assess the diagnostic reliability of polymerase chain reaction (PCR) on cerebrospinal fluid (CSF) for virus-associated opportunistic diseases of the central nervous system (CNS) in HIV-infected patients. Design: CSF samples from 500 patients with HIV infection and CNS symptoms were examined by PCR. In 219 patients the PCR results were compared with CNS histological findings. Methods: Nested PCR for detection of herpes simplex virus (HSV) type 1 or 2, varicella tester virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), and JC virus (JCV) DNA. Histopathological examination of CNS tissue obtained at autopsy or on brain biopsy. Results: DNA of one or more viruses was found in CSF in 181 out of 500 patients (36{\%}; HSV-1 2{\%}, HSV-2 1{\%}, VZV 3{\%}, CMV 16{\%}, EBV 12{\%}, HHV-6 2{\%}, and JCV 9{\%}). Among the 219 patients with histological CNS examination, HSV-1 or 2 was detected in CSF in all six patients (100{\%}) with HSV infection of the CNS, CMV in 37 out of 45 (82{\%}) with CMV infection of the CNS, EBV in 35 out of 36 (97{\%}) with primary CNS lymphoma, JCV in 28 out of 39 (72{\%}) with progressive multifocal leukoencephalopathy. Furthermore, HSV-1 was found in one, VZV in four, CMV in three, EBV in three, HHV-6 in seven, and JCV in one patient without histological evidence of the corresponding CNS disease. Conclusions: CSF PCR has great relevance for diagnosis of virus-related opportunistic CNS diseases in HIV-infected patients as demonstrated by its high sensitivity, specificity, and the frequency of positive findings.",
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author = "Paola Cinque and Luca Vago and Helena Dahl and Maria Brytting and Terreni, {Maria Rosa} and Carla Fornara and Sara Racca and Antonella Castagna and Monforte, {Antonella D Arminio} and Britta Wahren and Adriano Lazzarin and Annika Linde",
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T1 - Polymerase chain reaction on cerebrospinal fluid for diagnosis of virus-associated opportunistic diseases of the central nervous system in HIV-infected patients

AU - Cinque, Paola

AU - Vago, Luca

AU - Dahl, Helena

AU - Brytting, Maria

AU - Terreni, Maria Rosa

AU - Fornara, Carla

AU - Racca, Sara

AU - Castagna, Antonella

AU - Monforte, Antonella D Arminio

AU - Wahren, Britta

AU - Lazzarin, Adriano

AU - Linde, Annika

PY - 1996

Y1 - 1996

N2 - Objective: To assess the diagnostic reliability of polymerase chain reaction (PCR) on cerebrospinal fluid (CSF) for virus-associated opportunistic diseases of the central nervous system (CNS) in HIV-infected patients. Design: CSF samples from 500 patients with HIV infection and CNS symptoms were examined by PCR. In 219 patients the PCR results were compared with CNS histological findings. Methods: Nested PCR for detection of herpes simplex virus (HSV) type 1 or 2, varicella tester virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), and JC virus (JCV) DNA. Histopathological examination of CNS tissue obtained at autopsy or on brain biopsy. Results: DNA of one or more viruses was found in CSF in 181 out of 500 patients (36%; HSV-1 2%, HSV-2 1%, VZV 3%, CMV 16%, EBV 12%, HHV-6 2%, and JCV 9%). Among the 219 patients with histological CNS examination, HSV-1 or 2 was detected in CSF in all six patients (100%) with HSV infection of the CNS, CMV in 37 out of 45 (82%) with CMV infection of the CNS, EBV in 35 out of 36 (97%) with primary CNS lymphoma, JCV in 28 out of 39 (72%) with progressive multifocal leukoencephalopathy. Furthermore, HSV-1 was found in one, VZV in four, CMV in three, EBV in three, HHV-6 in seven, and JCV in one patient without histological evidence of the corresponding CNS disease. Conclusions: CSF PCR has great relevance for diagnosis of virus-related opportunistic CNS diseases in HIV-infected patients as demonstrated by its high sensitivity, specificity, and the frequency of positive findings.

AB - Objective: To assess the diagnostic reliability of polymerase chain reaction (PCR) on cerebrospinal fluid (CSF) for virus-associated opportunistic diseases of the central nervous system (CNS) in HIV-infected patients. Design: CSF samples from 500 patients with HIV infection and CNS symptoms were examined by PCR. In 219 patients the PCR results were compared with CNS histological findings. Methods: Nested PCR for detection of herpes simplex virus (HSV) type 1 or 2, varicella tester virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), and JC virus (JCV) DNA. Histopathological examination of CNS tissue obtained at autopsy or on brain biopsy. Results: DNA of one or more viruses was found in CSF in 181 out of 500 patients (36%; HSV-1 2%, HSV-2 1%, VZV 3%, CMV 16%, EBV 12%, HHV-6 2%, and JCV 9%). Among the 219 patients with histological CNS examination, HSV-1 or 2 was detected in CSF in all six patients (100%) with HSV infection of the CNS, CMV in 37 out of 45 (82%) with CMV infection of the CNS, EBV in 35 out of 36 (97%) with primary CNS lymphoma, JCV in 28 out of 39 (72%) with progressive multifocal leukoencephalopathy. Furthermore, HSV-1 was found in one, VZV in four, CMV in three, EBV in three, HHV-6 in seven, and JCV in one patient without histological evidence of the corresponding CNS disease. Conclusions: CSF PCR has great relevance for diagnosis of virus-related opportunistic CNS diseases in HIV-infected patients as demonstrated by its high sensitivity, specificity, and the frequency of positive findings.

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KW - Epstein-Barr virus

KW - Herpes simplex virus

KW - HIV

KW - Human herpesvirus-6

KW - JC virus

KW - Polymerase chain reaction

KW - Varicella zoster virus

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