Unveiling the Impact of Human Herpesviruses-Associated on CNS Infections: An Observational Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Site
2.2. Ethical Considerations
2.3. Study Population and Sample Collection
2.4. Data Collection
2.5. Case Definition
2.6. Molecular Diagnosis
2.7. Data Analysis
3. Results
3.1. Patient Characteristics and Clinical Diagnosis
3.2. Neurological Manifestations
3.3. PLWHA and Herpesviruses
3.4. CSF Sample Profile
3.5. Comparison between PLWHA and Non-HIV
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Demografic Caracteristic | Meningitis (N = 21) | Encephalitis (N = 31) | Meningoencephalitis (N = 8) | p Value |
---|---|---|---|---|
Sex (masc:fem) | 14:7 | 13:18 | 3:5 | 0.2 |
Age [Md] | 34.4 [7–91] | 36.3 [<1–77] | 43.2 [23–65] | 0.4 |
Etiological Agent | ||||
HSV-1 1 | 2 (9.5%) | 1 (3.2%) | 1 (12.5%) | 0.8 |
HSV-2 2 | 1 (4.7%) | 4 (13%) | 1 (12.5%) | |
VZV 3 | 6 (28.5%) | 6 (19.3%) | 0 | |
EBV 4 | 4 (19%) | 9 (29%) | 3 (37.5%) | |
HCMV 5 | 7 (33.3%) | 8 (25.8%) | 2 (25%) | |
Coinfections | 1 (4.7%) | 3 (9.6%) | 1 (12.5%) | |
Symptoms | ||||
Fever | 17 (81%) | 21 (68%) | 8 (100%) | 0.13 |
Headache | 17 (81%) | 16 (52%) | 7 (88%) | 0.036 |
Vomit | 10 (48%) | 13 (42%) | 7 (88%) | 0.069 |
Neck stiffness | 12 (57.1%) | 1 (3.2%) | 6 (75%) | <0.001 |
Decreased alertness | 2 (9.5%) | 28 (90.3%) | 7 (87.5%) | <0.001 |
Seizure | 0 | 9 (29%) | 0 | 0.007 |
Muscle weakness | 5 (24%) | 10 (32.2%) | 1 (12.5%) | 0.5 |
HIV 6 | ||||
Yes | 11 (52.3%) | 19 (61.2%) | 6 (75%) | 0.6 |
No | 10 (47.6%) | 12 (38.7%) | 2 (25%) | |
Outcome | ||||
Discharge | 19 (90.4%) | 14 (67.7%) | 3 (43%) | 0.021 |
Died | 2 (9.5%) | 10 (32.2%) | 2 (25%) | 0.11 |
Symptoms of PLWHA 1 | Meningitis N = 11 (%) | Encephalitis N = 19 (%) | Meningoencephalitis N = 6 (%) | p Value |
---|---|---|---|---|
Fever | 10 (91%) | 11 (58%) | 6 (100%) | 0.040 |
Vomit | 5 (45%) | 8 (42%) | 5 (83%) | 0.2 |
Headache | 11 (100%) | 11 (58%) | 5 (83%) | 0.032 |
Neck stifness | 5 (45.4%) | 0 | 4 (66.6%) | <0.001 |
Decreased alertness | 2 (18%) | 19 (100%) | 5 (83%) | <0.001 |
Seizure | 0 | 6 (32%) | 0 | 0.040 |
Muscle weakness | 4 (36%) | 7 (37%) | 0 | 0.2 |
Stage of AIDS 2 | ||||
Stage 1 * (n = 1) | 0 | 0 | 0 | - |
Stage 2 ** (n = 6) | 2 (18%) | 3 (16%) | 1 (17%) | <0.9 |
Stage 3 *** (n = 24) | 7 (64%) | 15 (79%) | 2 (33%) | 0.11 |
Unknow stage **** (n = 6) | 2 (18%) | 1 (5.3%) | 3 (50%) | 0.037 |
Outcome | ||||
Died | 2 (18%) | 10 (53%) | 2 (33%) | 0.2 |
Discharge | 9 (82%) | 6 (32%) | 2 (33%) | 0.022 |
Biochemical Parameters | Meningitis N = 21 | Escephalitis N = 31 | Meningoencephalitis N = 8 | p Value |
---|---|---|---|---|
Cytometry (cell/mm3) | 85 (5–320) | 182 (31–480) | 259 (106–473) | <0.9 |
Glucose (mg/dL) | 64 (45–75) | 54 (45–68) | 77 (42–105) | 0.4 |
Proteins (mg/dL) | 121 (59–161) | 139 (66–206) | 93 (68–133) | 0.6 |
Lactate (mmol/L) | 4 (3–24) | 20 (4–34) | 32 (10–42) | 0.053 |
Variables (Total) Neurological Disease (N = 67) | PLWHA 1 (N = 39) | Non-HIV/AIDS 2 (N = 28) | p Value |
---|---|---|---|
Meningitis (n = 21) | 10 (25.6%) | 11(39.2%) | 0.35 |
Encephalitis (n = 31) | 19 (48.7%) | 12 (42.8%) | 0.82 |
Meningoencephalitis (n = 8) | 6 (15.3%) | 2 (7.14%) | 0.45 |
No information of diagnosis (n = 7) | 3 (7.7%) | 4 (14.2%) | 0.43 |
Viral agent | |||
HCMV 3 (n = 18) | 10 (25.6%) | 8 (28.55) | 0.99 |
EBV 4 (n = 17) | 14 (35.8%) | 3 (10.7%) | 0.04 |
VZV 5 (n = 14) | 7 (18%) | 7 (25%) | 0.69 |
HSV-2 6 (n = 6) | 0 | 6 (21.4%) | - |
HSV-1 7 (n = 5) | 1 (2.5%) | 4 (14.2%) | 0.15 |
Symptons | |||
Fever (n = 50) | 28 (71.8%) | 22 (78.5%) | 0.73 |
Vomit (n = 32) | 19 (48.7%) | 13 (46.4%) | 0.94 |
Headache (n = 44) | 29 (74.3%) | 15 (53.5%) | 0.13 |
Neckstifness (n = 19) | 9 (23%) | 10 (35.7%) | 0.39 |
Decreased alertness (n = 39) | 26 (66.6%) | 13 (46.4%) | 0.15 |
Seizure (n = 9) | 6 (15.3%) | 3 (10.7%) | 0.72 |
Muscle weakness (n = 18) | 12 (30.7%) | 6 (21.4%) | 0.56 |
Outcome and hospitalization | |||
Discharge | 25 (64.1%) | 28 (100%) | - |
Died | 14 (35.89%) | 0 | |
Hospital care (days) | 1–245 (39.6) | 3–35 (12.4) | <0.05 |
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Barrionuevo, C.C.L.B.; Baptista, P.P.A.; da Silva, E.F.; da Silva, B.M.; Goulart, C.d.L.; de Melo, S.A.; da Silva, V.A.; de Souza, L.L.A.; Monte, R.L.; Almeida-Val, F.F.; et al. Unveiling the Impact of Human Herpesviruses-Associated on CNS Infections: An Observational Study. Viruses 2024, 16, 1437. https://doi.org/10.3390/v16091437
Barrionuevo CCLB, Baptista PPA, da Silva EF, da Silva BM, Goulart CdL, de Melo SA, da Silva VA, de Souza LLA, Monte RL, Almeida-Val FF, et al. Unveiling the Impact of Human Herpesviruses-Associated on CNS Infections: An Observational Study. Viruses. 2024; 16(9):1437. https://doi.org/10.3390/v16091437
Chicago/Turabian StyleBarrionuevo, Caio Cesar L. B., 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, and et al. 2024. "Unveiling the Impact of Human Herpesviruses-Associated on CNS Infections: An Observational Study" Viruses 16, no. 9: 1437. https://doi.org/10.3390/v16091437