Gaeta Aurelia, Verzaro Simona, Cristina Latte Maria, Mancini Carlo, Nazzari Cristina
Clinical Microbiology Department of Science and Public Health, Sapienza University of Rome, Italy.
New Microbiol. 2009 Oct;32(4):333-40.
Human herpesviruses (HHVs) cause many serious acute and persistent central nervous system (CNS) disorders. Because these infections manifest with various, often non-specific, symptoms and signs, and because specific therapy is often available, accurate diagnosis is essential. Cerebrospinal fluid (CSF) from 146 patients with acute meningitis or meningoencephalitis and 9 with "other neurological disorders" were analyzed by using an automatic system for nucleic acid extraction and quantitative real-time polymerase chain reaction (PCR) for herpes simplex 1 and 2 (HSV-1, HSV-2), Epstein-Barr virus (EBV), human cytomegalovirus (HCMV), herpesvirus-6 (HHV-6), and varicella-zoster virus (VZV). HHVs DNA was detected in 52 of 155 (33.5%) analyzed samples. In 39 CSF samples from patients with meningoencephalitis we found: VZV in 13, HSV-1 in 12, EBV in 6, HHV-6 in 4, and HSV-2 in 4. Co-infections of EBV and HSV-2, HSV-1 and HSV-2, HSV-1 and VZV were also disclosed in four cases. In addition, two patients with Guillain-Barré syndrome had HCMV and one showed HHV6 positivity, two patients with myelitis / polymyeloradiculitis had VZV and HCMV respectively, HHV-6 DNA was found in one patient with lateral amyotrophic sclerosis. Three CSF specimens from HIV-infected patients with CNS complications had HHV-6 or EBV DNA. Moreover quantitative data were also correlated to clinical conditions to obtain more information on the virus aetiopathogenic role.
人类疱疹病毒（HHV）可引发多种严重的急性和持续性中枢神经系统（CNS）疾病。由于这些感染表现出各种通常是非特异性的症状和体征，且往往有特效疗法，因此准确诊断至关重要。采用自动核酸提取系统和针对单纯疱疹病毒1型和2型（HSV-1、HSV-2）、爱泼斯坦-巴尔病毒（EBV）、人巨细胞病毒（HCMV）、疱疹病毒6型（HHV-6）和水痘-带状疱疹病毒（VZV）的定量实时聚合酶链反应（PCR），对146例急性脑膜炎或脑膜脑炎患者以及9例“其他神经系统疾病”患者的脑脊液（CSF）进行了分析。在155份分析样本中，有52份（33.5%）检测到HHV DNA。在39份脑膜脑炎患者的脑脊液样本中，我们发现：13份样本中检测到VZV，12份样本中检测到HSV-1，6份样本中检测到EBV，4份样本中检测到HHV-6，4份样本中检测到HSV-2。另外，4例患者还发现了EBV与HSV-2、HSV-1与HSV-2、HSV-1与VZV的合并感染。此外，2例吉兰-巴雷综合征患者的脑脊液中检测到HCMV，1例患者的脑脊液中检测到HHV6阳性；2例脊髓炎/多发性神经根炎患者的脑脊液中分别检测到VZV和HCMV；1例侧索肌萎缩硬化症患者的脑脊液中检测到HHV-6 DNA。3份来自合并中枢神经系统并发症的HIV感染患者的脑脊液样本中检测到HHV-6或EBV DNA。此外，还将定量数据与临床情况相关联，以获取更多关于病毒致病作用的信息。
