Detection of both herpes simplex and varicella‐zoster viruses in cerebrospinal fluid from patients with encephalitis

Casas, Inmaculada; Tenorio, Antonio; Ory, Fernando de; Lozano, Álvaro; Echevarría, José Manuel

doi:10.1002/(sici)1096-9071(199609)50:1<82::aid-jmv14>3.0.co;2-#

Cited by 26 publications

(14 citation statements)

References 33 publications

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“…A tentative diagnosis of HSV encephalitis can be performed by the demonstration of intrathecally produced anti-HSV antibodies as expressed in an increased ratio of HSV CSF and serum antibodies. By using immunoprecipitation, radioimmunoassay, enzyme-linked immunosorbent assay (ELISA), and immunoblotting, several authors suggested that an increased CSF-toserum antibody ratio is a reliable measure for the diagnosis of HSV encephalitis (5,10,15,20,26,31). By contrast, other authors hypothesized that prolonged antigen stimulation is present in the CNS after acute HSV encephalitis and that serological measurements combined with immunoglobulin and albumin determinations provide only a tentative, not definite, diagnosis (18).…”

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confidence: 99%

Laboratory Diagnosis of Common Herpesvirus Infections of the Central Nervous System by a Multiplex PCR Assay

et al. 2001

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A sensitive multiplex PCR assay for single-tube amplification that detects simultaneous herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), varicella-zoster virus (VZV), human cytomegalovirus (CMV), and Epstein-Barr virus (EBV) is reported with particular emphasis on how the method was optimized and carried out and its sensitivity was compared to previously described assays. The assay has been used on a limited number of clinical samples and must be thoroughly evaluated in the clinical context. A total of 86 cerebrospinal fluid (CSF) specimens from patients which had the clinical symptoms of encephalitis, meningitis or meningoencephalitis were included in this study. The sensitivity of the multiplex PCR was determined to be 0.01 and 0.03 50% tissue culture infective doses/the reciprocal of the highest dilution positive by PCR for HSV-1 and HSV-2 respectively, whereas for VZV, CMV and EBV, 14, 18, and 160 ag of genomic DNA were detected corresponding to 48, 66, and 840 genome copies respectively. Overall, 9 (10.3%) of the CSF samples tested were positive in the multiplex PCR. HSV-1 was detected in three patients (3.5%) with encephalitis, VZV was detected in four patients (4.6%) with meningitis, HSV-2 was detected in one neonate (1.16%), and CMV was also detected in one neonate (1.16%). None of the samples tested was positive for the EBV genome. None of the nine positive CSF samples presented herpesvirus coinfection in the central nervous system. Failure of DNA extraction or failure to remove any inhibitors of DNA amplification from CSF samples was avoided by the inclusion in the present multiplex PCR assay of ␣-tubulin primers. The present multiplex PCR assay detects simultaneously five different herpesviruses and sample suitability for PCR in a single amplification round of 40 cycles with an excellent sensitivity and can, therefore, provide an early, rapid, reliable noninvasive diagnostic tool allowing the application of antiviral therapy on the basis of a specific viral diagnosis. The results of this preliminary study should prompt a more exhaustive analysis of the clinical value of the present multiplex PCR assay.

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Laboratory Diagnosis of Common Herpesvirus Infections of the Central Nervous System by a Multiplex PCR Assay

et al. 2001

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“…Another possible interpretation of the presence of antibodies to both HSV-1 and VZV in CSF samples would be a response to dual infections. This was suggested in a study of 46 patients with suspected HSE in which 7/46 patients had both VZV DNA and HSV 1-DNA detected in the CSF samples by qualitative PCR (3).…”

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confidence: 95%

Varicella-Zoster Virus (VZV) Glycoprotein E Is a Serological Antigen for Detection of Intrathecal Antibodies to VZV in Central Nervous System Infections, without Cross-Reaction to Herpes Simplex Virus 1

Grahn

Studahl

Nilsson

et al. 2011

Clin. Vaccine Immunol.

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Herpes simplex virus 1 (HSV-1) and varicella-zoster virus (VZV) cause serious central nervous system (CNS) diseases that are diagnosed with PCR using samples of cerebrospinal fluid (CSF) and, during later stages of such infections, with assays of intrathecal IgG antibody production. However, serological diagnoses have been hampered by cross-reactions between HSV-1 and VZV IgG antibodies and are commonly reported in patients with herpes simplex encephalitis (HSE). In this study we have evaluated VZV glycoprotein E (gE) as a new antigen for serological diagnosis of VZV-induced CNS infections. Paired samples of CSF and serum from 29 patients with clinical diagnosis of VZV CNS infection (n ‫؍‬ 15) or HSE (n ‫؍‬ 14), all confirmed by PCR, were analyzed. VZV gE and whole VZV were compared as antigens in enzyme-linked immunosorbent assays (ELISAs) for serological assays in which the CSF/serum sample pairs were diluted to identical IgG concentrations. With the gE antigen, none of the HSE patients showed intrathecal IgG antibodies against VZV, compared to those shown by 11/14 patients using whole-VZV antigen (P < 0.001). In the patients with VZV infections, significantly higher CSF/serum optical density (OD) ratios were found in the VZV patients using the VZV gE antigen compared to those found using the whole-VZV antigen (P ‫؍‬ 0.001). These results show that gE is a sensitive antigen for serological diagnosis of VZV infections in the CNS and that this antigen was devoid of cross-reactivity to HSV-1 IgG in patients with HSE. We therefore propose that VZV gE can be used for serological discrimination of CNS infections caused by VZV and HSV-1.

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“…Virological confirmation is required in the case of zosteriform herpes simplex and in atypical VZV and HSV infections of immunosuppressed patients (1). Both primary and recurrent HSV or VZV infections may lead to CNS infection and disease (2).…”

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confidence: 99%

“…Sensitivity and specificity may vary with different primer pairs and the genetic variability of naturally occurring strains of viruses is an important influencing factor. Many different primer pairs have been suggested for the diagnosis of HSV and VZV infections (1,2,8,(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Detection and typing of HSV-1, HSV-2, and VZV by a multiplex polymerase chain reaction

Markoulatos

Georgopoulou

Kotsovassilis

et al. 2000

J. Clin. Lab. Anal.

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The development of a multiplex polymerase chain reaction method for the rapid and accurate detection and typing of HSV‐1, HSV‐2, and VZV from clinical specimens is described. A sensitive multiplex polymerase chain reaction was achieved by optimization of parameters such as the primers, magnesium, and dNTPs concentrations. False‐negative results that sometimes arise due to inhibitors of DNA amplification or failure of DNA extraction procedure used may be avoided by assaying each specimen with α‐tubulin primers. Multiplex PCR amplified viral sequences from all 55 specimens obtained from patients with clinical evidence of HSV or VZV infection indicated 100% sensitivity. From 55 patients who were investigated by multiplex PCR, HSV‐1 was detected in 28, HSV‐2 in 20, and VZV in 7 specimens. The reported results indicate that the present multiplex PCR assay has a potential application in clinical diagnosis when a rapid and accurate detection and typing of involved viruses HSV‐1, HSV‐2, or VZV is needed. J. Clin. Lab. Anal. 14:214–219, 2000. © 2000 Wiley‐Liss, Inc.

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Detection of both herpes simplex and varicella‐zoster viruses in cerebrospinal fluid from patients with encephalitis

Cited by 26 publications

References 33 publications

Laboratory Diagnosis of Common Herpesvirus Infections of the Central Nervous System by a Multiplex PCR Assay

Laboratory Diagnosis of Common Herpesvirus Infections of the Central Nervous System by a Multiplex PCR Assay

Varicella-Zoster Virus (VZV) Glycoprotein E Is a Serological Antigen for Detection of Intrathecal Antibodies to VZV in Central Nervous System Infections, without Cross-Reaction to Herpes Simplex Virus 1

Detection and typing of HSV-1, HSV-2, and VZV by a multiplex polymerase chain reaction

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