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Molecular detection of human herpesvirus 7 DNA in cerebrospinal fluid from adult patients with neurological disorders.
J Neurovirol. 2018 06; 24(3):333-338.JN

Abstract

Neurological manifestations associated with HHV-7 have been described in primary infection in children, and very occasionally in immunocompromised adult patients. However, the role of HHV-7 reactivation as a cause of central nervous system (CNS) diseases in immunocompetent adults has not yet been defined. We retrospectively analyzed clinical and microbiological features of adults with neurological symptoms who underwent lumbar puncture and a multiplex polymerase chain reaction (PCR) for herpesviruses (HHV-1-8) and enteroviruses performed in cerebrospinal fluid (CSF), during a 4-year period. A total of 251 subjects were included. Mean age was 55 years, ranging 15-89. Globally, HHV-7 DNA was detected in CSF in 14 patients (5.6%). It was detected in 1 of 36 patients with microbiologically confirmed CNS infections, and in 7 of 172 patients with diagnoses of non-infectious neurological disorders (Specificity 0.96, 95% confidence interval 0.93-0.99). Additionally, HHV-7 DNA was detected in 6 of 21 patients (28.6%) with probable CNS infections (compatible clinical syndrome and CSF changes) in the absence of other causative agent: four meningitis, one myelitis, and one encephalitis. Treatment with foscarnet was effective in achieving improvement of symptoms and clearance of HHV-7 DNA in CSF in the cases of encephalitis and myelitis, while ganciclovir was ineffective in the case of encephalitis. Our results show that HHV-7 reactivation may cause CNS disease in immunocompetent adults and that detection of HHV-7 DNA in CSF as a false-positive result or as asymptomatic reactivation in adult patients with neurological diseases is uncommon. Foscarnet seems the first-line treatment for HHV-7 CNS disease.

Authors+Show Affiliations

Servicio de Neurología, Hospital Universitario Ramón y Cajal, Madrid, Spain. icorral.hrc@salud.madrid.org.Servicio de Neurología, Hospital Universitario Ramón y Cajal, Madrid, Spain.Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain. CIBER en Epidemiología y Salud Pública, Madrid, Spain.Servicio de Neurología, Hospital Universitario Ramón y Cajal, Madrid, Spain.Servicio de Neurología, Hospital Universitario Ramón y Cajal, Madrid, Spain.Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain. CIBER en Epidemiología y Salud Pública, Madrid, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29536269

Citation

Corral, Íñigo, et al. "Molecular Detection of Human Herpesvirus 7 DNA in Cerebrospinal Fluid From Adult Patients With Neurological Disorders." Journal of Neurovirology, vol. 24, no. 3, 2018, pp. 333-338.
Corral Í, Sainz de la Maza S, Rodríguez M, et al. Molecular detection of human herpesvirus 7 DNA in cerebrospinal fluid from adult patients with neurological disorders. J Neurovirol. 2018;24(3):333-338.
Corral, Í., Sainz de la Maza, S., Rodríguez, M., Kawiorski, M. M., López-Martínez, M. J., & Galán, J. C. (2018). Molecular detection of human herpesvirus 7 DNA in cerebrospinal fluid from adult patients with neurological disorders. Journal of Neurovirology, 24(3), 333-338. https://doi.org/10.1007/s13365-018-0618-4
Corral Í, et al. Molecular Detection of Human Herpesvirus 7 DNA in Cerebrospinal Fluid From Adult Patients With Neurological Disorders. J Neurovirol. 2018;24(3):333-338. PubMed PMID: 29536269.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Molecular detection of human herpesvirus 7 DNA in cerebrospinal fluid from adult patients with neurological disorders. AU - Corral,Íñigo, AU - Sainz de la Maza,Susana, AU - Rodríguez,Mario, AU - Kawiorski,Michal-Maciej, AU - López-Martínez,María-José, AU - Galán,Juan-Carlos, Y1 - 2018/03/13/ PY - 2017/12/07/received PY - 2018/02/05/accepted PY - 2018/01/28/revised PY - 2018/3/15/pubmed PY - 2019/11/9/medline PY - 2018/3/15/entrez KW - Cerebrospinal fluid KW - Encephalitis KW - Human hervesvirus 7 KW - Meningitis KW - Myelitis KW - Polymerase chain reaction SP - 333 EP - 338 JF - Journal of neurovirology JO - J. Neurovirol. VL - 24 IS - 3 N2 - Neurological manifestations associated with HHV-7 have been described in primary infection in children, and very occasionally in immunocompromised adult patients. However, the role of HHV-7 reactivation as a cause of central nervous system (CNS) diseases in immunocompetent adults has not yet been defined. We retrospectively analyzed clinical and microbiological features of adults with neurological symptoms who underwent lumbar puncture and a multiplex polymerase chain reaction (PCR) for herpesviruses (HHV-1-8) and enteroviruses performed in cerebrospinal fluid (CSF), during a 4-year period. A total of 251 subjects were included. Mean age was 55 years, ranging 15-89. Globally, HHV-7 DNA was detected in CSF in 14 patients (5.6%). It was detected in 1 of 36 patients with microbiologically confirmed CNS infections, and in 7 of 172 patients with diagnoses of non-infectious neurological disorders (Specificity 0.96, 95% confidence interval 0.93-0.99). Additionally, HHV-7 DNA was detected in 6 of 21 patients (28.6%) with probable CNS infections (compatible clinical syndrome and CSF changes) in the absence of other causative agent: four meningitis, one myelitis, and one encephalitis. Treatment with foscarnet was effective in achieving improvement of symptoms and clearance of HHV-7 DNA in CSF in the cases of encephalitis and myelitis, while ganciclovir was ineffective in the case of encephalitis. Our results show that HHV-7 reactivation may cause CNS disease in immunocompetent adults and that detection of HHV-7 DNA in CSF as a false-positive result or as asymptomatic reactivation in adult patients with neurological diseases is uncommon. Foscarnet seems the first-line treatment for HHV-7 CNS disease. SN - 1538-2443 UR - https://www.unboundmedicine.com/medline/citation/29536269/Molecular_detection_of_human_herpesvirus_7_DNA_in_cerebrospinal_fluid_from_adult_patients_with_neurological_disorders_ L2 - https://dx.doi.org/10.1007/s13365-018-0618-4 DB - PRIME DP - Unbound Medicine ER -