Infektološki glasnik, Vol. 42 No. 4, 2022.
Izvorni znanstveni članak
https://doi.org/10.37797/ig.42.4.1
Clinical significance of Epstein-Barr virus DNA quantification in the cerebrospinal fluid: villain, accomplice, or innocent bystander?
Neven Papić
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska; Medicinski fakultet Sveučilišta u Zagrebu, Zagreb, Hrvatska
Marija Santini
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska; Medicinski fakultet Sveučilišta u Zagrebu, Zagreb, Hrvatska
Josip Begovac
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska; Medicinski fakultet Sveučilišta u Zagrebu, Zagreb, Hrvatska
Adriana Vince
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska; Medicinski fakultet Sveučilišta u Zagrebu, Zagreb, Hrvatska
Snježana Židovec Lepej
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
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* Dopisni autor.
Sažetak
Objective: Clinical significance of Epstein-Barr (EBV) virus DNA in the cerebrospinal fluid (CSF) is not fully understood. Our aim was to evaluate clinical implications of detectable EBV DNA in the cerebrospinal fluid (CSF) of immunocompetent and immunocompromised patients in the context of their final diagnosis.
Methods: This was a single-center, retrospective cohort study that included all consecutively hospitalized adult patients whose CSF samples were referred for PCR-based detection of EBV DNA in the period between January 2008 and December 2019. The patients were classified as having encephalitis according to the International Encephalitis Consortium case definition.
Results: EBV DNA was detectable in 54/646 CSF samples (8.4%) from 37 patients. Of 34 patients included in this analysis, 15 patients were diagnosed with an immunocompromising condition including advanced HIV disease (n=12), solid organ transplantation (n=2) and chronic lymphocytic leukemia (n=1). The most frequent clinical diagnosis in HIV-infected patients included biopsy-proven primary CNS lymphoma (PCNSL, n=5) and toxoplasmosis (n=3). Six of 15 immunocompromised patients died (including 4/5 with CNSL). The immunocompetent group (n=19) included patients with viral CNS infections (n=6), EBV encephalitis (n=5), postinfectious meningoencephalitis (n=1), autoimmune encephalitis (n=1), neurotuberculosis (n=1) and five patients with uncertain etiology. Four patients died during hospitalization (all with unknown etiology). Patients with EBV encephalitis were treated with acyclovir (n=4) and corticosteroids (n=5) and they all improved.
Conclusions: CSF EBV-DNA is of highest clinical significance in patients with advanced HIV disease and primary CNS lymphoma, but it requires careful interpretation in immunocompetent adults, particularly those with CNS co-infections.
Ključne riječi
Epstein-Barr virus; central nervous system; cerebrospinal fluid; HIV; immunocompetent patients
Hrčak ID:
338848
URI
Datum izdavanja:
19.11.2025.
Posjeta: 50 *