Characterizing Epstein-Barr virus infection of the central nervous system in Zambian adults living with HIV

Kalo Musukuma-Chifulo*, Musie Ghebremichael, Obvious Nchimunya Chilyabanyama, Matthew Bates, Sody Munsaka, Michelo Simuyandi, Caroline Chisenga, John Tembo, Edford Sinkala, Igor J. Koralnik, Xin Dang, Roma Chilengi, Omar K. Siddiqi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

The significance of Epstein-Barr virus (EBV) detection in the cerebrospinal spinal fluid (CSF) in people living with HIV (PLWH) is not entirely understood. The detection of EBV DNA may represent active central nervous system (CNS) infection, reactivation in the setting of another CNS pathogen or due to impaired immunity, or detection of quiescent virus. We screened 470 adult PLWH in Zambia with neurological symptoms for the presence of EBV DNA in the CSF. We performed quantitative EBV PCR on the CSF and blood. We then performed quantitative EBV DNA PCR on the blood of controls with documented HIV viral suppression without CNS symptoms. The prevalence of EBV DNA in the CSF of patients with CNS symptoms was 28.9% (136/470). EBV DNA positivity was associated with younger age, shorter duration of HIV diagnosis, lower CSF glucose levels, higher CSF protein and white blood cell levels, and a positive CSF Mycobacterium tuberculosis result. The median EBV DNA load was 8000 cps/mL in both the CSF and blood with a range of 2000–2,753,000 cps/mL in the CSF and 1000 to 1,871,000 cps/mL in the blood. Molecular screening of CSF for other possible causes of infection identified Mycobacterium tuberculosis in 30.1% and cytomegalovirus (CMV) in 10.5% of samples. EBV DNA load in the blood and CSF was not associated with mortality. Our results suggest that even though EBV DNA was commonly detected in the CSF of our population, it appears to have limited clinical significance regardless of EBV DNA load.

Original languageEnglish (US)
Pages (from-to)706-712
Number of pages7
JournalJournal of neurovirology
Volume29
Issue number6
DOIs
StatePublished - Dec 2023

Keywords

  • Central nervous system
  • Epstein-Barr virus
  • HIV
  • Zambia

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Cellular and Molecular Neuroscience
  • Virology

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