Incidence of viral agents in cerebrospinal liquid. One-year experience

Abstract

Hematogenous and/or traumatic encephalitis is caused by more than 100 viruses. The incidence increases with treatment with immunosuppressants and the increased survival of patients with the acquired immunodeficiency virus (HIV). Symptoms include fever, changes in consciousness, and seizures. The diagnosis is made by molecular biology and neuroimaging. Objectives: To evaluate the incidence of viral infections of the central nervous system through samples of cerebrospinal fluid (CSF) and to analyze the relationship between the immune status and viral positivity. Materials and methods: Retrospective descriptive analysis of CSF samples from 71 patients with suspected viral encephalitis/ meningoencephalitis. RTqPCR (Cobas Z480 Roche) was used and statistically evaluated with SPSS 27.0. Results: Fifteen samples were positive for the viruses studied: Herpes simplex virus 1 (HSV-1): 1.52%, herpes simplex virus 2 (HSV-2): 1.52%, Varicella Zoster Virus (VZV): 0%, non-polio human enterovirus (hEV): 1.47%, Cytomegalovirus (CMV): 7.69%, and Epstein-Barr virus (EBV): 23.1%. About 36.6% of the patients (26/71) were immunocompetent and 63.3% (45/71) were immunosuppressed (32 HIV, 11 newborns, 2 with immunosuppressive treatment). The association between the patient’s immune status and each virus was analyzed using Fisher’s test. An association was found for CMV (p-value 0.400), EBV (pvalue 0.316), but not for HSV-1, HSV-2 (p-value 0.621) or hEV (0.647). Discussion: Results showed 21.1% positivity, similar to that previously found in Argentina and Brazil, but lower than that found in Switzerland (44.18%). The variability highlights the importance of considering the population and the environment. Due to the limited number of positive samples, further investigation is required to corroborate the hypothesis.