Detection of Epstein-Barr virus and Kaposi's sarcoma-associated herpesvirus DNA in CSF from persons infected with HIV who had neurological disease

摘要

OBJECTIVES—Todetermine the frequency and clinical relevance of Epstein-Barr virus(EBV) and Kaposi's sarcoma associated herpesvirus (KSHV) DNA detectionin the CSF from patients infected with HIV.
METHODS—Cerebrospinalfluid was obtained prospectively from 115 consecutive patients infectedwith HIV undergoing diagnostic lumbar puncture for investigation ofneurological disease. Amplification of DNA was performed using a nestedpolymerase chain reaction (PCR) for detection of EBV internal repeatand KSHV minor capsid sequences.
RESULTS—EBVDNA was detected in the CSF supernatant of 18 patients. This includedall patients with primary CNS lymphoma (seven patients) or acombination of systemic and CNS lymphoma (two patients). By contrastEBV DNA was not detected in the CSF supernatant of any patient withsystemic, but not CNS, lymphoma (10 patients). EBV DNA was alsodetected in the supernatant of nine further patients without adiagnosis of lymphoma at the time of lumbar puncture, two of whomsubsequently developed CNS lymphoma. No EBV DNA was detected in CSFsupernatant from the remaining 87 samples (two of these patientssubsequently developed lymphoma). KSHV DNA was detected in the CSF oftwo patients, one had systemic (but not CNS) lymphoma and the other didnot have lymphoma.
CONCLUSION—Adiagnosis of CNS lymphoma is strongly associated with the presence ofEBV DNA in CSF. In the absence of clinical and radiological features ofCNS lymphoma, the presence of detectable CSF EBV DNA may predictsubsequent tumour development. KSHV DNA is rarely detected in CSF inthis patient group and shows no correlation with lymphoma or otherneurological disease.