Casas I, Tenorio A, de Ory F, Lozano A, Echevarría J M
Department of Diagnosis, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
J Med Virol. 1996 Sep;50(1):82-92. doi: 10.1002/(SICI)1096-9071(199609)50:1<82::AID-JMV14>3.0.CO;2-#.
Cerebrospinal fluid (CSF) samples from 46 patients with encephalitis were studied for the presence of herpes simplex virus (HSV) types 1 and 2 and/or varicella zoster virus (VZV)-specific DNA sequences by the polymerase chain reaction (PCR) assay. Patients were studied because of detection of intrathecal production of IgG antibody to HSV alone (10 patients, Group A) or to both HSV and VZV (11 patients, Group B) or because of the presence of specific anti-HSV IgG in CSF without evidence of intrathecal antibody production (25 patients, Group C). CSF samples taken between days 1 and 10 from onset of encephalitis were available from all patients, and follow-up samples (taken after 10 days from onset) were obtained from some of them. Positive PCR results were obtained in a total of 13 patients. Four patients (three from Group A and one from Group B) gave amplification of HSV type 1 DNA alone, two patients (both from Group B) showed amplification of VZV DNA alone, and seven patients (all from Group B) gave dual amplification of both HSV type 1 and VZV DNA sequences in CSF. All CSF samples from patients in Group C were negative by PCR. Ten patients with CSF samples positive by PCR lacked a prior history of herpetic cutaneous lesions. In seven patients, serum antibody tests (specific IgM detection and specific IgG avidity assays) identified both primary and recurrent infections. The results suggest that the dual presence of IgG antibody to both HSV and VZV in CSF from patients with encephalitis may reflect in some cases a dual infection of the central nervous system caused by both agents.
采用聚合酶链反应（PCR）分析法，对46例脑炎患者的脑脊液（CSF）样本进行研究，以检测1型和2型单纯疱疹病毒（HSV）及/或水痘带状疱疹病毒（VZV）的特异性DNA序列。研究这些患者的原因包括：单独检测到鞘内产生抗HSV IgG抗体（10例患者，A组），或同时检测到抗HSV和抗VZV IgG抗体（11例患者，B组），或脑脊液中存在特异性抗HSV IgG但无鞘内抗体产生的证据（25例患者，C组）。所有患者均有发病后第1天至第10天采集的脑脊液样本，部分患者还获得了随访样本（发病后10天以后采集）。共有13例患者PCR结果呈阳性。4例患者（3例来自A组，1例来自B组）仅扩增出1型HSV DNA，2例患者（均来自B组）仅扩增出VZV DNA，7例患者（均来自B组）脑脊液中1型HSV和VZV DNA序列均呈双重扩增。C组所有患者的脑脊液样本PCR检测均为阴性。10例脑脊液样本PCR阳性的患者既往无疱疹性皮肤病变史。7例患者通过血清抗体检测（特异性IgM检测和特异性IgG亲和力检测）确定为原发性和复发性感染。结果表明，脑炎患者脑脊液中同时存在抗HSV和抗VZV IgG抗体，在某些情况下可能反映中枢神经系统由这两种病原体引起的双重感染。
