Institute of Virology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Kumasi Centre for Collaborative Research Into Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Virol J. 2022 Jul 26;19(1):122. doi: 10.1186/s12985-022-01854-7.
Encephalitis is a serious disease of the brain characterized by prodromal and specific neurological symptoms. HIV infections offer opportunistic viruses, such as Varicella-zoster virus (VZV), the chance to cause encephalitis in patients. There is a lack of information on the genetic diversity of VZV in Ghana and other parts of Africa which requires sequencing and characterization studies to address. The active evolution of HIV-1 in West Africa also requires continuous surveillance for the emergence of new genetic forms.
VZV was detected in the CSF sample of an 11-year-old patient presenting with symptoms of encephalitis by real-time PCR diagnostics. To identify possible unknown aetiological pathogens, next-generation sequencing was performed, and revealed an HIV-1 co-infection. Alignments of concatenated HIV-1 genome fragments in the gag, pol, vif, env and nef regions and a near-complete VZV genome were analyzed by Bayesian inference, and phylogenetic trees were generated. The VZV sequence belongs to clade 5 and the HIV-1 sequence is a member of the CRF02_AG predominant circulating recombinant form in Ghana.
Diagnostic tests for CSF HIV would be useful where possible in patients presenting with encephalitis due to VZV and other opportunistic viruses in Kumasi to shed light on the role of HIV in encephalitis cases in Ghana. This report reaffirms the role of the CRF02_AG circulating recombinant form in HIV infections in Ghana and also gives a preliminary genetic characterization of VZV in Kumasi, Ghana.
脑炎是一种严重的脑部疾病，其特征是前驱期和特定的神经症状。HIV 感染为水痘-带状疱疹病毒（VZV）等机会性病毒提供了机会，使患者患上脑炎。目前缺乏加纳和非洲其他地区 VZV 遗传多样性的信息，需要进行测序和特征研究。HIV-1 在西非的活跃进化也需要持续监测新遗传形式的出现。
通过实时 PCR 诊断，在一名 11 岁出现脑炎症状患者的 CSF 样本中检测到 VZV。为了确定可能未知的病因病原体，进行了下一代测序，结果显示存在 HIV-1 合并感染。对 gag、pol、vif、env 和 nef 区拼接的 HIV-1 基因组片段和近乎完整的 VZV 基因组进行贝叶斯推断分析，并生成系统发育树。VZV 序列属于 5 组，HIV-1 序列是加纳流行的 CRF02_AG 主要循环重组形式的成员。
在库马西，对出现 VZV 和其他机会性病毒引起的脑炎的患者，尽可能进行 CSF HIV 检测诊断将很有用，可以阐明 HIV 在加纳脑炎病例中的作用。本报告再次证实了 CRF02_AG 循环重组形式在加纳 HIV 感染中的作用，并初步对加纳库马西的 VZV 进行了遗传特征分析。
