Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Senne Liquor Diagnóstico, São Paulo, Brazil.
J Med Virol. 2024 Feb;96(2):e29471. doi: 10.1002/jmv.29471.
Human enteroviruses (EV) are the most common cause of aseptic meningitis worldwide. Data on EV viral load in cerebrospinal fluid (CSF) and related epidemiological studies are scarce in Brazil. This study investigated the influence of EV viral load on CSF parameters, as well as identifying the involved species. CSF samples were collected in 2018-2019 from 140 individuals at The Hospital das Clínicas, São Paulo. The EV viral load was determined using real-time quantitative polymerase chain reaction, while EV species were identified by 5'UTR region sequencing. Median viral load was 5.72 log copies/mL and did not differ by subjects' age and EV species. Pleocytosis was observed in 94.3% of cases, with the highest white blood cell (WBC) counts in younger individuals. Viral load and WBC count were correlated in children (p = 0.0172). Elevated lactate levels were observed in 60% of cases and correlated with the viral load in preteen-teenagers (p = 0.0120) and adults (p = 0.0184). Most individuals had normal total protein levels (70.7%), with higher in preteen-teenagers and adults (p < 0.0001). By sequencing, 8.2% were identified as EV species A and 91.8% as species B. Age-specific variations in CSF characteristics suggest distinct inflammatory responses in each group.
人类肠道病毒（EV）是全球无菌性脑膜炎的最常见病因。关于巴西脑脊液（CSF）中 EV 病毒载量的相关数据和流行病学研究很少。本研究旨在调查 EV 病毒载量对 CSF 参数的影响，并鉴定相关病毒。2018 年至 2019 年期间，从圣保罗市临床医院的 140 名个体中采集 CSF 样本。使用实时定量聚合酶链反应（PCR）测定 EV 病毒载量，通过 5'UTR 区测序鉴定 EV 种。中位病毒载量为 5.72 log 拷贝/mL，与研究对象的年龄和 EV 种无差异。94.3%的病例存在白细胞增多症，年轻个体的白细胞计数最高。儿童的病毒载量与白细胞计数呈正相关（p=0.0172）。60%的病例乳酸水平升高，与青少年和成人的病毒载量呈正相关（p=0.0120 和 p=0.0184）。大多数个体的总蛋白水平正常（70.7%），青少年和成人的总蛋白水平较高（p<0.0001）。通过测序，8.2%鉴定为 EV 种 A，91.8%鉴定为 EV 种 B。CSF 特征的年龄特异性变化提示每组存在不同的炎症反应。
