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Quantitative CSF PCR in Epstein–Barr virus infections of the central nervous system
Author(s) -
Weinberg Adriana,
Li Shaobing,
Palmer Megan,
Tyler Kenneth L.
Publication year - 2002
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.10321
Subject(s) - lytic cycle , cerebrospinal fluid , virus , meningoencephalitis , encephalitis , epstein–barr virus , polymerase chain reaction , herpesviridae , viral load , virology , immunology , viral encephalitis , epstein–barr virus infection , real time polymerase chain reaction , biology , central nervous system , gammaherpesvirinae , serology , cytomegalovirus , viral disease , medicine , pathology , antibody , gene , biochemistry , neuroscience
Abstract Acute Epstein–Barr virus (EBV) infection of the central nervous system (CNS) is associated with meningoencephalitis and other neurological syndromes and with CNS lymphomas (CNSLs). Diagnosis is based on serological studies and more recently on detection of EBV DNA in cerebrospinal fluid (CSF) by polymerase chain reaction (PCR). We measured EBV DNA by quantitative PCR and EBV mRNA by RT‐PCR in the CSF in patients with EBV‐associated neurological disorders. EBV was identified as the cause of CNS infection in 28 patients: 14 with CNSL, 10 with encephalitis, and 4 with postinfectious neurological complications. CSF analysis showed that patients with CNSL had high EBV load (mean ± standard error of 4.8 ± 0.2 log 10 DNA copies/ml) and low leukocyte counts (22 ± 7 cells/μl); encephalitis was characterized by high EBV load (4.2 ± 0.3 log 10 DNA copies/ml) and high leukocyte counts (143 ± 62 cells/μl); and patients with postinfectious complications showed low EBV load (3.0 ± 0.2 log 10 DNA copies/ml) with high leukocyte counts (88 ± 57 cells/μl). Lytic cycle EBV mRNA, a marker of viral replication, was identified in 10 CSF samples from patients with CNSL and encephalitis. These studies demonstrate the utility of quantitative CSF PCR and establish the presence of lytic cycle EBV mRNA in CSF of patients with EBV‐associated neurological disease.