Epstein–Barr Virus Detection in the Central Nervous System of HIV-Infected Patients

Musukuma, Kalo; Siddiqi, Omar K.; Chilyabanyama, Obvious Nchimunya; Bates, Matthew; Chisenga, Caroline Cleopatra; Simuyandi, Michelo; Sinkala, Edford; Dang, Xin; Koralnik, Igor J.; Chilengi, Roma; Munsaka, Sody

doi:10.3390/pathogens11101080

Cited by 4 publications

(2 citation statements)

References 60 publications

(107 reference statements)

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“…Research has demonstrated that infection of the CNS with EBV in people living with HIV is associated with reactivated EBV [29]. Although the presence of EBV in the CNS remains a concern, co‐infections in EBV seem to play an important role in the success of its reactivation [30]. Early initiation of combination ART to help restore impaired immune surveillance and T‐cells is still an essential factor in the control of EBV for people living with HIV.…”

Section: Discussionmentioning

confidence: 99%

Microbiomes detected by cerebrospinal fluid metagenomic next‐generation sequencing among patients with and without HIV with suspected central nervous system infection

Zou,

Chen,

Tan

et al. 2024

HIV Medicine

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BackgroundOpportunistic infections in the central nervous system (CNS) can be a serious threat to people living with HIV. Early aetiological diagnosis and targeted treatment are crucial but difficult. Metagenomic next‐generation sequencing (mNGS) has significant advantages over traditional detection methods. However, differences in the cerebrospinal fluid (CSF) microbiome profiles of patients living with and without HIV with suspected CNS infections using mNGS and conventional testing methods have not yet been adequately evaluated.MethodsWe conducted a retrospective cohort study in the first hospital of Changsha between January 2019 and June 2022 to investigate the microbiomes detected using mNGS of the CSF of patients living with and without HIV with suspected CNS infections. The pathogens causing CNS infections were concurrently identified using both mNGS and traditional detection methods. The spectrum of pathogens identified was compared between the two groups.ResultsOverall, 173 patients (140 with and 33 without HIV) with suspected CNS infection were enrolled in our study. In total, 106 (75.7%) patients with and 16 (48.5%) patients without HIV tested positive with mNGS (p = 0.002). Among the enrolled patients, 71 (50.7%) with HIV and five (15.2%) without HIV tested positive for two or more pathogens (p < 0.001). Patients with HIV had significantly higher proportions of fungus (20.7% vs. 3.0%, p = 0.016) and DNA virus (59.3% vs. 21.2%, p < 0.001) than those without HIV. Epstein–Barr virus (33.6%) was the most commonly identified potential pathogen in the CSF of patients living with HIV using mNGS, followed by cytomegalovirus (20.7%) and torque teno virus (13.8%). The top three causative pathogens identified in patients without HIV were Streptococcus (18.2%), Epstein–Barr virus (12.1%), and Mycobacterium tuberculosis (9.1%). In total, 113 patients living with HIV were diagnosed as having CNS infections. The rate of pathogen detection in people living with HIV with a CNS infection was significantly higher with mNGS than with conventional methods (93.8% vs. 15.0%, p < 0.001).ConclusionCSF microbiome profiles differ between patients living with and without HIV with suspected CNS infection. mNGS is a powerful tool for the diagnosis of CNS infection among people living with HIV, especially in those with mixed infections.

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Section: Discussionmentioning

confidence: 99%

Microbiomes detected by cerebrospinal fluid metagenomic next‐generation sequencing among patients with and without HIV with suspected central nervous system infection

Zou,

Chen,

Tan

et al. 2024

HIV Medicine

View full text Add to dashboard Cite

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“…A recent meta-analysis revealed that EBV is detectable in the cerebrospinal fluid (CSF) of approximately 20% of HIV-positive patients without lymphoma. 31 Similarly to JCV, in situations of cellular immunodeficiency, EBV can shift into an intensified replication state. 32 In addition to possibly causing symptomatic infections such as encephalitis, meningitis, and myelitis, EBV is also suspected to have a key role in the development of lymphoproliferative diseases.…”

Section: Introductionmentioning

confidence: 99%

Combined treatment with allogeneic Epstein–Barr- and human polyomavirus 1 specific T-cells in progressive multifocal leukoencephalopathy and EBV infection: a case report

Nay,

Möhn,

Grote-Levi

et al. 2024

Ther Adv Neurol Disord

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Opportunistic viral infections in individuals with severe immunodeficiency can lead to fatal conditions such as progressive multifocal leukoencephalopathy (PML), for which treatment options are limited. These infections pose significant risks, especially when co-infections with other viruses occur. We describe a combined therapy approach using directly isolated allogeneic Human Polyomavirus 1 (also known as BKV) and Epstein–Barr virus (EBV) specific cytotoxic T-cells for the treatment of PML in conjunction with identified EBV in the cerebrospinal fluid (CSF) of a male patient infected with human immunodeficiency virus (HIV). A 53-year-old HIV-positive male, recently diagnosed with PML, presented with rapidly worsening symptoms, including ataxia, tetraparesis, dysarthria, and dysphagia, leading to respiratory failure. The patient developed PML even after commencing highly active antiretroviral therapy (HAART) 3 months prior. Brain magnetic resonance imaging (MRI) revealed multifocal demyelination lesions involving the posterior fossa and right thalamus suggestive of PML. In addition to the detection of human polyomavirus 2 (also known as JCV), analysis of CSF showed positive results for EBV deoxyribonucleic acid (DNA). His neurological condition markedly deteriorated over the following 2 months. Based on MRI, there was no evidence of Immune Reconstitution Inflammatory Syndrome contributing to this decline. The patient did not have endogenous virus-specific T-cells. We initiated an allogeneic, partially human leukocyte antigen-matched transfer of EBV and utilizing the cross-reactivity between BKV and JCV–BKV specific T-cells. This intervention led to notable neurological improvement and partial resolution of the MRI lesions within 6 weeks. Our case of a patient with acquired immune deficiency syndrome demonstrates that PML and concurrent EBV co-infection can still occur despite undergoing HAART treatment. This innovative experimental therapy, involving a combination of virus-specific T-cells, was demonstrated to be an effective treatment option in this patient.

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Characterizing Epstein-Barr virus infection of the central nervous system in Zambian adults living with HIV

Musukuma-Chifulo,

Ghebremichael,

Chilyabanyama

et al. 2023

J. Neurovirol.

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Epstein–Barr Virus Detection in the Central Nervous System of HIV-Infected Patients

Cited by 4 publications

References 60 publications

Microbiomes detected by cerebrospinal fluid metagenomic next‐generation sequencing among patients with and without HIV with suspected central nervous system infection

Microbiomes detected by cerebrospinal fluid metagenomic next‐generation sequencing among patients with and without HIV with suspected central nervous system infection

Combined treatment with allogeneic Epstein–Barr- and human polyomavirus 1 specific T-cells in progressive multifocal leukoencephalopathy and EBV infection: a case report

Characterizing Epstein-Barr virus infection of the central nervous system in Zambian adults living with HIV

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