Detection of herpesvirus genomes by polymerase chain reaction in cerebrospinal fluid.pdf

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Detection of herpesvirus genomes by polymerase chain reaction in cerebrospinal fluid.pdf

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Detection of herpesvirus genomes by polymerase chain reaction in cerebrospinal fluid

Journal of Clinical Virology 25 (2002) S59–S70 Detection of herpesvirus genomes by polymerase chain reaction in cerebrospinal fluid and clinical findings Sophie Minjolle a, C. Arvieux b, A.L. Gautier a, I. Jusselin a, R. Thomas b, C. Michelet b, Ronald Colimon a,* a Laboratoire de Bacte?riologie–Virologie, Uniersite? Rennes 1, 2 aenue, du Pr Le?on Bernard, CS 34317, 35 043 Rennes cedex, France b Serice de Re?animation et des Maladies Infectieuses, CHU Pontchaillou, Rennes, France Abstract Background: The viruses of the Herpesviridae family, in particular herpes simplex virus types 1 (HSV-1) and 2 (HSV-2), cytomegalovirus (CMV), Epstein–Barr virus (EBV), varicella zoster virus (VZV), and human herpesvirus 6 (HHV-6), are responsible for numerous infections of the central nervous system (CNS). These infections manifest as diverse clinical signs, many of which are not specific. The diagnosis of these infections is necessary to make it possible to adapt treatment appropriately, as treatment is specific for the particular virus concerned. Objecties: To apply a polymerase chain reaction (PCR) technique for the diagnosis in a single reaction of the six herpesviruses most frequently detected in the cerebrospinal fluid (CSF) and to analyse clinical events in patients presenting positive results in PCR for herpesviruses. Study design: We studied 141 patients, from whom 180 CSF samples were collected. The clinical files of the patients were consulted retrospectively, and a list of clinical signs was recorded. After testing by targeted PCR, at the clinician’s demand, we tested these samples by herpes consensus PCR, which detects six herpesviruses (HSV-1, HSV-2, CMV, EBV, VZV, HHV-6), in a single PCR. Results: Targeted PCR tests identified 25 CSF samples (13.9%), corresponding to 18 patients (12%), as positive. The herpes consensus PCR test detected 49 samples (27.2%) as positive, resulting in the identification of 54 individual viruses (four samples displayed co-infec- tion)