揭示人类疱疹病毒相关病毒对中枢神经系统感染的影响:观察研究

Viruses Pub Date : 2024-09-09 DOI:10.3390/v16091437
Caio Cesar L. B. Barrionuevo, Pedro P. A. Baptista, Ewerton F. da Silva, Bernardo M. da Silva, Cássia da L. Goulart, Sabrina A. de Melo, Valderjane A. da Silva, Lara Laycia A. de Souza, Rossicleia L. Monte, Fernando F. Almeida-Val, Pablo Vinícius S. Feitoza, Michele de S. Bastos
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摘要

人类疱疹病毒(HHV)在脑炎和脑膜炎等神经系统疾病中发挥着重要作用,并增加了大量发病率。本研究旨在回顾性分析 HHVs 对神经系统症状患者的影响,重点研究疱疹病毒科对中枢神经系统(CNS)感染的贡献。研究方法这项回顾性队列研究纳入了 895 名疑似中枢神经系统病毒感染的患者,通过 qPCR 进行分子诊断,以确定脑脊液 (CSF) 样本中的 HHVs。这项研究于 2015 年 1 月至 2022 年 12 月在巴西亚马逊河西部的一家传染病参考三级医院进行,重点研究疱疹病毒科的临床反响以及巨细胞病毒在中枢神经系统感染中的作用。结果研究结果显示,7.5% 的分析样本对巨细胞病毒检测呈阳性,其中以人类巨细胞病毒(HCMV)和爱泼斯坦-巴尔病毒(EBV)最为普遍。研究发现,HHVs 与脑炎和脑膜炎等神经系统疾病有明显关联,尤其是在艾滋病毒/艾滋病感染者(PLWHA)中,这凸显了这些病毒的机会性。这项研究强调了 CSF 分析在诊断中枢神经系统感染中的关键作用,以及由于 HIV 患者的免疫功能低下,管理这些感染的复杂性。结论:研究结果表明,对于免疫功能低下者的中枢神经系统感染,需要采用全面的诊断方法和有针对性的治疗策略。该研究呼吁继续开展研究并改进临床实践,以改善中枢神经系统感染(尤其是由 HHV 引起的感染)患者的治疗效果。
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Unveiling the Impact of Human Herpesviruses-Associated on CNS Infections: An Observational Study
Human Herpesviruses (HHVs) play a significant role in neurological diseases such as encephalitis and meningitis, adding significant morbidity. This study aims to retrospectively analyze the effect of HHVs on patients with neurological symptoms, focusing on the Herpesviridae family’s contributions to central nervous system (CNS) infections. Methods: This retrospective cohort study included 895 patients suspected of viral CNS infections, utilizing molecular diagnosis via qPCR to identify HHVs in cerebrospinal fluid (CSF) samples. This was conducted at a reference tertiary care hospital for infectious diseases in the western Brazilian Amazon from January 2015 to December 2022, focusing on the Herpesviridae family’s clinical repercussions and of Cytomegalovirus in CNS infections. Results: The findings revealed that 7.5% of the analyzed samples tested positive for HHVs, with Human Cytomegalovirus (HCMV) and Epstein–Barr Virus (EBV) being the most prevalent. A significant association was found between HHVs and neurological diseases such as encephalitis and meningitis, especially among people living with HIV/AIDS (PLWHA), highlighting the opportunistic nature of these viruses. The study underscores the critical role of CSF analysis in diagnosing CNS infections and the complexity of managing these infections in HIV patients due to their immunocompromised status. Conclusions: The results emphasize the need for comprehensive diagnostic approaches and tailored treatment strategies for CNS infections in immunocompromised individuals. The study calls for ongoing research and advancements in clinical practice to improve patient outcomes facing CNS infections, particularly those caused by HHVs.
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