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Cytomegalovirus infections of the nervous system
P Cinque1, R Marenzi, D Ceresa
1Department of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy. cinquep@rsisi.hsr.it
Abstract:
Experimental evidence and pathological observation indicate that human cytomegalovirus (HCMV) has a tropism for cells of the nervous system, including both neuronal and glial cells. As demonstrated in animal models, after a viremic phase, the virus may reach the brain, where it may cause mild infection or severe encephalitis. The nervous system is one of the principal target organs in congenital HCMV infections and in HCMV-infected AIDS patients. In the former case, mortality is high and neurological sequelae, such as mental retardation, are frequent; in the latter it may lead to a progressively wasting encephalopathy and death within a few weeks. The diagnosis of the nervous system manifestations due to HCMV can now rely upon the detection of HCMV DNA in cerebrospinal fluid by means of polymerase chain reaction. However, the current antiviral treatments of these complications are of limited effect.
Insights
Human cytomegalovirus (HCMV) targets the nervous system, causing encephalitis and severe neurological issues in infants and AIDS patients. Diagnosis is possible via PCR in cerebrospinal fluid, but treatments remain limited.
Area of Science:
- Neurovirology
- Infectious Diseases
- Neurology
Background:
- Human cytomegalovirus (HCMV) exhibits tropism for nervous system cells, including neurons and glial cells.
- Animal models show HCMV can reach the brain post-viremia, potentially causing encephalitis.
- The nervous system is a primary target in congenital HCMV and in AIDS patients.
Purpose of the Study:
- To review the impact of HCMV on the nervous system.
- To highlight diagnostic advancements and treatment limitations for HCMV neurological complications.
Main Methods:
- Review of experimental evidence and pathological observations.
- Analysis of findings in congenital HCMV infections and in HCMV-infected AIDS patients.
- Discussion of diagnostic methods like PCR for HCMV DNA in cerebrospinal fluid.
Main Results:
- HCMV infection of the nervous system can lead to mild or severe encephalitis.
- Congenital HCMV infections result in high mortality and neurological sequelae like mental retardation.
- In AIDS patients, HCMV encephalopathy can be rapidly fatal.
Conclusions:
- HCMV poses significant risks to the nervous system, particularly in vulnerable populations.
- Polymerase chain reaction (PCR) aids in diagnosing HCMV nervous system involvement.
- Current antiviral therapies for HCMV neurological complications demonstrate limited efficacy.