Journal Article

Herpes Simplex Virus Infections of the Central Nervous System in Human Immunodeficiency Virus—Infected Patients: Clinical Management by Polymerase Chain Reaction Assay of Cerebrospinal Fluid

Paola Cinque, Luca Vago, Roberta Marenzi, Barbara Giudici, Thomas Weber, Rita Corradini, Daniela Ceresa, Adriano Lazzarin and Annika Linde

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 2, pages 303-309
Published in print August 1998 | ISSN: 1058-4838
Published online August 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514657
Herpes Simplex Virus Infections of the Central Nervous System in Human Immunodeficiency Virus—Infected Patients: Clinical Management by Polymerase Chain Reaction Assay of Cerebrospinal Fluid

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A duplex polymerase chain reaction (PCR) assay for DNA from herpes simplex virus types 1 (HSV-1) and 2 (HSV-2) was applied to cerebrospinal fluid (CSF) from 918 human immunodeficiency virus (HIV)—infected patients with neurological symptoms. HSV-1 or HSV-2 (HSV-1/2) DNA was found in 19 patients (2%). For the 258 patients for whom a diagnosis was confirmed at autopsy, the sensitivity and specificity of PCR analysis for the diagnosis of HSV-1/2 encephalitis were 100% and 99.6%, respectively. Three patients with CD4+ cell counts of ⩾170/μL had HSV-1 central nervous system (CNS) infections (two) or HSV-2 meningitis (one). Sixteen patients with CD4+ cell counts of <40/μL had HSV-1 CNS infections (two) or mixed HSV-1/2 and cytomegalovirus encephalitis (14). The response to antiviral treatment, which was assessed clinically and by CSF PCR analysis, was variable in the patients with the highest CD4+ cell counts and poor in those with more severe immunosuppression. CSF PCR analysis is of value for the diagnosis and follow-up of treatment of HSV-1/2 CNS infections in HIV-infected patients.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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