Behzad-Behbahani A, Klapper P E, Vallely P J, Cleator G M, Bonington A
Clinical Virology Section, Organ Transplantation Research Center, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Infection. 2003 Dec;31(6):374-8. doi: 10.1007/s15010-003-3078-5.
Few studies have looked for the polyoma viruses JC or BK virus in the central nervous system (CNS) of patients without neurological symptoms or with neurological symptoms other than progressive multifocal leukoencephalopathy (PML). PCR-microplate hybridization method was employed for the detection of BKV-DNA or JCV-DNA in cerebrospinal fluid (CSF) specimens from patients with suspected meningitis or encephalitis.
A total of 181 CSF specimens from 151 patients with suspected meningitis or encephalitis was examined for BKV or JCV using PCR-microplate hybridization method. None of the patients had (clinically diagnosed) PML. A control group consisting of 20 CSF specimens from normal subject was also included.
BKV DNA was found in five out of 131 (3.8%) and JCV DNA in two out of 131 (1.5%) of the patients with suspected meningitis or encephalitis by PCR ELISA. BKV or JCV DNA was not detected in CSF samples of any of 19 HIV positive patients. BKV and JCV DNAs were detected respectively in two CSF samples in which Mycobacterium tuberculosis (TB) PCR was also positive. Another patient who was positive for JCV PCR died with a diagnosis of cerebral lymphoma. Among the BK virus infected patients there was a patient with a previous history of hemolytic uremia and acute renal failure. Neither BKV nor JCV DNA was found in any of the 20 CSF samples from normal patients undergoing lumbar puncture for myelography as a part of an investigation of lower back pain.
These results suggest that BK virus may be associated with neurological diseases either in immunocompetent or immunocompromised patients. Detection of BKV and JCV DNA in the CSF of the patients suspected to have either meningitis or encephalitis suggests that these viruses may have an etiological role. Thus, diagnostic tests for BK and JC viruses should be included in the investigative program for meningitis or encephalitis patients.
很少有研究在没有神经症状或有除进行性多灶性白质脑病（PML）以外神经症状的患者的中枢神经系统（CNS）中寻找多瘤病毒JC或BK病毒。采用聚合酶链反应-微孔板杂交法检测疑似脑膜炎或脑炎患者脑脊液（CSF）标本中的BKV-DNA或JCV-DNA。
使用聚合酶链反应-微孔板杂交法对151例疑似脑膜炎或脑炎患者的181份CSF标本进行BKV或JCV检测。所有患者均无（临床诊断的）PML。还纳入了一个由20份来自正常受试者的CSF标本组成的对照组。
通过聚合酶链反应酶联免疫吸附测定法，在131例疑似脑膜炎或脑炎患者中，有5例（3.8%）检测到BKV DNA，2例（1.5%）检测到JCV DNA。19例HIV阳性患者的CSF样本中均未检测到BKV或JCV DNA。在两份结核分枝杆菌（TB）聚合酶链反应也呈阳性的CSF样本中分别检测到了BKV和JCV DNA。另一名JCV聚合酶链反应呈阳性的患者被诊断为脑淋巴瘤后死亡。在感染BK病毒的患者中，有一名患者既往有溶血尿毒症和急性肾衰竭病史。在20份因腰痛接受腰椎穿刺进行脊髓造影检查的正常患者的CSF样本中，均未发现BKV和JCV DNA。
这些结果表明，BK病毒可能与免疫功能正常或免疫功能低下患者的神经疾病有关。在疑似患有脑膜炎或脑炎的患者的CSF中检测到BKV和JCV DNA表明这些病毒可能具有病因学作用。因此，对脑膜炎或脑炎患者的调查程序应包括对BK和JC病毒的诊断检测。
