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Epstein-Barr Virus Detection in the Central Nervous System of HIV-Infected Patients
Kalo Musukuma-Chifulo1,2, Omar Khalik Siddiqi3,4,5, Obvious Nchimunya Chilyabanyama2
1Department of Biomedical Science, School of Health Sciences, University of Zambia, Lusaka P.O. Box 50110, Zambia.
Insights
Detecting Epstein-Barr virus DNA in cerebrospinal fluid of HIV-positive patients without lymphoma is common, with a pooled prevalence of 20%. Its role in causing central nervous system disease remains unclear, especially in African populations.
Area of Science:
- Virology
- Neurology
- Infectious Diseases
Background:
- Epstein-Barr virus (EBV) DNA detection in cerebrospinal fluid (CSF) is crucial for diagnosing central nervous system (CNS) diseases.
- Simply detecting EBV DNA is insufficient for diagnosis, necessitating further investigation into its significance, particularly in human immunodeficiency virus (HIV)-positive individuals without lymphoma.
Purpose of the Study:
- To systematically review and meta-analyze the pooled prevalence of EBV DNA in CSF among HIV-positive non-lymphoma patients.
- To investigate the variability in PCR methods and gene targets used for EBV DNA detection in CSF.
Main Methods:
- A systematic literature search was conducted on PubMed using keywords related to EBV detection, CNS disease, and CSF.
- 13 studies met the inclusion criteria from 273 screened papers.
- A meta-analysis was performed to estimate the pooled prevalence of EBV DNA in CSF.
Main Results:
- The pooled prevalence of EBV DNA in CSF among HIV-positive non-lymphoma patients was 20% (CI: 12-31%).
- Studies from African populations showed a higher pooled prevalence of 39% (CI: 27-51%).
- Significant variation was observed in the PCR methods and gene targets employed for EBV DNA detection.
Conclusions:
- EBV DNA is frequently detected in the CSF of HIV-positive non-lymphoma patients, indicating a potential concern for CNS involvement.
- The pathogenicity of EBV in this population remains undetermined, highlighting the need for further research.
- Understanding the significance of EBV DNA in CSF is crucial for diagnosing and managing CNS disorders in HIV-positive individuals.
Abstract:
Simply detecting Epstein-Barr virus deoxyribonucleic acid (EBV-DNA) is insufficient to diagnose EBV-associated diseases. The current literature around EBV-DNA detection from cerebrospinal fluid (CSF) in human immunodeficiency virus (HIV)-positive non-lymphoma patients was systematically reviewed and a meta-analysis reporting the estimated pooled prevalence in this population when PCR methods are employed, targeting different sequence segments within the EBV genome, was conducted. Using a combination of three key concepts-Epstein-Barr virus detection, central nervous system disease, and human cerebrospinal fluid-and their MeSH terms, the PubMed database was searched. A total of 273 papers reporting the detection of EBV in CNS were screened, of which 13 met the inclusion criteria. The meta-analysis revealed a pooled prevalence of EBV-DNA in CSF of 20% (CI: 12-31%). The highest pooled prevalence was from studies conducted on the African population at 39% (CI: 27-51%). The investigation of the presence of EBV-DNA in the CSF was also very varied, with several gene targets used. While most patients from the articles included in this review and meta-analysis were symptomatic of CNS disorders, the pathogenicity of EBV in non-lymphoma HIV patients when detected in CSF has still not been determined. The presence of EBV-DNA in the CNS remains a concern, and further research is warranted to understand its significance in causing CNS disorders.
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