Quantitative CSF PCR in Epstein–Barr virus infections of the central nervous system

Weinberg, Adriana; Li, Shaobing; Palmer, Megan; Tyler, Kenneth L.

doi:10.1002/ana.10321

Cited by 125 publications

(101 citation statements)

References 26 publications

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“…The high EBV viral load in CSF (5.22 log copies/ml for the LightCycler EBV quantification kit and 4.67 log copies/ml for the RealArt EBV LC PCR kit) are in agreement with values previously reported (2,24). The LightCycler EBV quantification kit showed higher but wider distribution of viral load values than the RealArt EBV LC PCR kit.…”

Section: Discussionsupporting

confidence: 90%

Comparison of Commercial Real-Time PCR Assays for Quantification of Epstein-Barr Virus DNA

et al. 2005

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Clinical research suggests a role for viral load measurement in predicting and monitoring Epstein-Barr virus (EBV)-associated diseases. The aim of this study was to assess the performance of the recently commercially available quantitative assays for EBV based on real-time PCR: the RealArt EBV LC PCR kit and the LightCycler EBV quantification kit. A total of 87 samples were analyzed: 67 samples were obtained from transplant recipients and patients with EBV-associated diseases, 8 samples were obtained from the Quality Control for Molecular Diagnostics 2002 EBV Proficiency Program, and 12 negative qualitative nested PCR samples were used as negative controls. Inter-and intra-assay variabilities were determined by running replicates of two samples. All samples were run in a LightCycler instrument. The differences between positive and negative results were not considered statistically significant (P ‫؍‬ 0.5355). There were no false-positive results using either method for nested PCR negative-control samples. The difference in viral load values using the two different methods was considered statistically significant (P < 0.01). The logarithmic linear correlation for both assays was low (r ‫؍‬ 0.449) but significant (P < 0.01). The LightCycler EBV quantification kit showed a wider dispersal in results but produced substantially more-accurate melting temperature profile curves. The bias towards lower measurements was considerable in comparison with higher viral load. The differences in PCR efficiency and the presence of mutations could explain the disparity between the two methods. It was concluded that confidence intervals would be required to report the results rather than plain absolute values of viral load for patient monitoring.Epstein-Barr virus (EBV) is a human herpesvirus included in the Gammaherpesvirinae subfamily and is the only human species belonging to the genus Lymphocryptovirus (11). EBV infects more than 90% of the world's population, leaving the majority of individuals with a lifelong silent infection (14). Although most primary EBV infections are asymptomatic, the virus is the causative agent of infectious mononucleosis, a mild and self-limited lymphoproliferative disease (13). EBV is associated with the development of two epithelial tumors, nasopharyngeal carcinoma (5) and oral hairy leukoplakia, seen mainly in human immunodeficiency virus infection (3), as well as with various lymphoid carcinomas, lymphoproliferative disease in immunosuppressed patients, Burkitt's lymphoma, Hodgkin's disease, and T-cell non-Hodgkin's lymphoma (25).EBV DNA is present in a small fraction of lymphoid cells, and healthy virus carriers harbor 1 to 50 EBV genomes per 10 6 mononuclear cells, with B lymphocytes representing the major cellular reservoir (9). Qualitative PCR assays are unable to distinguish between active and latent infection. Consequently, clinical interpretation of positive results is difficult. However, clinical research suggests a role for viral load measurement in predicting and monitoring EBV-associate...

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Section: Discussionsupporting

confidence: 90%

Comparison of Commercial Real-Time PCR Assays for Quantification of Epstein-Barr Virus DNA

et al. 2005

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“…Finally, DNA microarray technology, which is a multiplex endpoint PCR system, did not allow the quantitation of the viral load in the clinical samples. However, it has been assumed that quantitation of viral nucleic acids may be useful in monitoring the effectiveness of antiviral therapy and for establishing the prognosis of the disease (9,28,43).…”

Section: Discussionmentioning

confidence: 99%

Rapid Virological Diagnosis of Central Nervous System Infections by Use of a Multiplex Reverse Transcription-PCR DNA Microarray

Lévêque¹,

Haecke²,

Renois³

et al. 2011

J Clin Microbiol

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“…Although typical MRI findings of EBV encephalitis are hypointensity in T1 weighted and hyperintensity in T2 weighted images with lack of diffusion restriction, a wide spectrum of imaging abnormalities ranging from normal to diffuse signal intensity changes either in grey or white matter can be seen (2, 7−10). The role of cerebrospinal fluid PCR in diagnosis of EBV infections of the nervous system remains to be determined because positive EBV PCR may be seen in patients with other viral or non-viral infections of the CNS (5,11,12). However, the diagnosis of EBV infection is ascertained by the detection of EBV PCR and a weakly positive VCA-IgM titre in the cerebrospinal fluid and serum.…”

Section: Discussionmentioning

confidence: 99%

Epstein-Barr Virus Encephalitis in Infancy

Gurbuz¹,

Gürbüz²,

Çayır³

et al. 2014

West Indian Med J

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infection (4). Therefore, EBV has to be considered in a variety of acute neurologic illnesses. Although EBV encephalitis is a well-known entity, it is extremely rare under one year of age. Here, we report a 10-month old infant with EBV encephalitis. CASE REPORTA 10-month old male child was admitted with a three-day history of febrile infection and seizures. Physical examination revealed a temperature of 38.7˚C, blood pressure of 90/50 mmHg, pulse rate of 120/minute and respiratory rate of 36/minute. The patient was confused. There were hepatomegaly, splenomegaly and membranous tonsillitis. A complete blood count showed haematocrit of 24%, white blood cell (WBC) count of 22 000 cells/µL (58% neutrophils, 32% lymphocytes, 8% monocytes), and a platelet count of 155 000 cells/µL. A few atypical lymphocytes were observed in his blood smear. Blood chemistries including transaminases and a chest radiogram were normal. Meningitis was suspected and a lumbar puncture was performed revealing 50 Epstein-Barr Virus Encephalitis in Infancy

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Quantitative CSF PCR in Epstein–Barr virus infections of the central nervous system

Cited by 125 publications

References 26 publications

Comparison of Commercial Real-Time PCR Assays for Quantification of Epstein-Barr Virus DNA

Comparison of Commercial Real-Time PCR Assays for Quantification of Epstein-Barr Virus DNA

Rapid Virological Diagnosis of Central Nervous System Infections by Use of a Multiplex Reverse Transcription-PCR DNA Microarray

Epstein-Barr Virus Encephalitis in Infancy

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