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BKPyV causing meningoencephalitis in HIV/AIDS patients in Argentina
Viviana Raskovsky1, Sebastián Blanco2, Federico Perrote3
1Laboratorio de Virus Respiratorios y Neurovirosis, Hospital Señor del Milagro, Salta, Argentina.
Abstract:
Opportunistic infections in the central nervous system (CNS) by JCPyV/BKPyV in HIV/AIDS patients increase morbidity/mortality, especially in low-income countries. In Argentina, data regarding CNS-infection by polyomavirus in HIV/AIDS are scarce. We retrospectively evaluated BKPyV/JCPyV infections in cerebrospinal fluid (CSF) samples of HIV/AIDS patients with meningoencephalitis or Progressive Multifocal Leukoencephalopathy (PML) from Salta, Argentina, a province with high rates of mortality from AIDS. Cryopreserved CSF samples from all HIV/AIDS patients with BKPyV/JCPyV admitted to a regional referral hospital for one year underwent amplification of 173 pb T-antigen sequence by PCR, searching for polyomavirus DNA. Subsequently, polyomavirus genotyping by direct sequencing was performed. Six percent (3/50) of the patients with CNS disorders had polyomavirus; one patient with meningoencephalitis had BKPyV, and 2 patients with PML had JCPyV. One genotype 2A was identified. To our knowledge, this is the first description of BKPyV-associated meningoencephalitis in HIV/AIDS patients in Argentina, together with the first report of JCPyV genotype 2 responsible for neurological disease in a patient with HIV/AIDS in the country. These data support the systematic incorporation of molecular diagnosis for BKPyV /JCPyV into routine screening of CSF in patients with HIV/AIDS and neurological diseases in Argentina. Etiological diagnosis of CNS diseases in these patients is overriding.
Insights
This study found BK polyomavirus (BKPyV) and JC polyomavirus (JCPyV) in HIV/AIDS patients with CNS disorders in Argentina. These opportunistic infections highlight the need for routine molecular diagnostics in this population.
Area of Science:
- Neurovirology
- Infectious Diseases
- Public Health
Background:
- Opportunistic central nervous system (CNS) infections by JC polyomavirus (JCPyV) and BK polyomavirus (BKPyV) significantly increase morbidity and mortality in individuals with HIV/AIDS, particularly in resource-limited settings.
- Data on polyomavirus CNS infections in HIV/AIDS patients in Argentina are limited, despite the province of Salta experiencing high AIDS-related mortality rates.
Purpose of the Study:
- To investigate the prevalence and genotypes of BKPyV and JCPyV infections in the cerebrospinal fluid (CSF) of HIV/AIDS patients presenting with meningoencephalitis or Progressive Multifocal Leukoencephalopathy (PML) in Salta, Argentina.
- To establish the etiological role of these polyomaviruses in neurological disease within this specific patient cohort.
Main Methods:
- A retrospective analysis of cryopreserved CSF samples from HIV/AIDS patients admitted to a regional referral hospital over one year.
- Polyomavirus DNA detection using PCR amplification of the T-antigen sequence, followed by genotyping through direct sequencing.
Main Results:
- Polyomavirus DNA was detected in 6% (3/50) of patients with CNS disorders.
- BKPyV was identified in one patient with meningoencephalitis, and JCPyV was found in two patients with PML.
- The identified JCPyV strain was genotype 2A, marking the first report of this genotype causing neurological disease in an HIV/AIDS patient in Argentina.
Conclusions:
- This study provides the first description of BKPyV-associated meningoencephalitis in HIV/AIDS patients in Argentina.
- It also reports the first instance of JCPyV genotype 2 causing neurological disease in an HIV/AIDS patient in the country.
- The findings underscore the importance of incorporating molecular diagnostics for BKPyV/JCPyV into routine CSF screening for HIV/AIDS patients with neurological conditions in Argentina to ensure timely etiological diagnosis.
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