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Presence of Epstein-Barr virus in cerebrospinal fluid is associated with increased mortality in HIV-negative

Yi Lu1,2, Shubo Li3, Zhihui Su1

  • 1Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China.

Medical Mycology
|May 6, 2024
PubMed

Insights

Epstein-Barr virus (EBV) DNA in cerebrospinal fluid (CSF) is common in HIV-negative patients with cryptococcal meningitis (CM). Its presence significantly increases the risk of mortality within 10 weeks.

Area of Science:

  • Infectious Diseases
  • Virology
  • Neuroscience

Background:

  • Cryptococcus neoformans causes fungal meningitis with high mortality.
  • The role of concurrent Epstein-Barr virus (EBV) in HIV-negative patients with cryptococcal meningitis (CM) is not well understood.

Purpose of the Study:

  • To investigate the prevalence of viral DNA in CSF of HIV-negative CM patients.
  • To determine the association between Epstein-Barr virus (EBV) DNA and mortality in this patient group.

Main Methods:

  • Retrospective cohort study of 79 HIV-negative Chinese Han patients with CM.
  • Metagenomic next-generation sequencing (mNGS) used to detect viral DNA in CSF samples.
  • Comparison of 10-week survival rates between patients with and without CSF EBV DNA.

Main Results:

  • Viral DNA was detected in 44.3% of CSF samples; EBV was the most frequent virus (22.8%).
  • Patients with EBV DNA in CSF had a significantly higher 10-week mortality rate (22.2% vs. 2.3%).
  • This association remained significant after multivariate adjustment for known mortality risk factors.

Conclusions:

  • Metagenomic next-generation sequencing (mNGS) effectively identifies co-infecting viruses in CSF.
  • Epstein-Barr virus (EBV) DNA in CSF is associated with increased mortality in HIV-negative patients with cryptococcal meningitis (CM).
Keywords:
Epstein–Barr virusHIV-negativecryptococcal meningitismetagenomic next-generation sequencingmortality

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