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Quantitative real time PCR detection of Varicella-zoster virus DNA in cerebrospinal fluid in patients with neurological disease

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Abstract

Varicella-zoster virus (VZV) reactivation can lead to the development of neurological disease. Diagnosis has been based on the detection of VZV DNA in cerebrospinal fluid (CSF) by PCR-based methods. The aim of this study was to determine whether the VZV DNA copy number in the CSF correlates with the course of the disease and to determine its prognostic relevance. VZV DNA was quantified in CSF samples obtained from 30 patients with neurological disease due to VZV reactivation using real time PCR, and the VZV DNA copy number was correlated to the clinical and laboratory findings for each case. Viral loads ranged from 50 copies/ml to 2.6×108 copies/ml. Significantly higher viral loads [geometric mean (GM): 7.2 x 104 copies/ml] were found in patients with encephalitis compared to patients with meningitis (GM: 4.1×103 copies/ml) (P=0.01, Mann-Whitney U test). In eight patients without zoster dermal lesions no significant difference in viral load (GM: 4.6×103) was detected compared to patients exhibiting dermal lesions (GM: 2.2×104) (P=0.14). High copy numbers of VZV DNA in CSF were clearly associated with the severity of neurological disease and none of the patients with a VZV viral load below 104 copies had a disease course which required intensive care.

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Acknowledgements

We would like to thank Karin Kraus for excellent technical assistance and Heidemarie Holzmann and Therese Popow-Kraupp for critical reading of the manuscript.

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Authors and Affiliations

  1. Institute of Virology, Medical University of Vienna, Kinderspitalgasse 15, 1095, Vienna, Austria

    Stephan W. Aberle, Judith H. Aberle, Christoph Steininger & Elisabeth Puchhammer-Stöckl

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  1. Stephan W. Aberle
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  2. Judith H. Aberle
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  3. Christoph Steininger
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  4. Elisabeth Puchhammer-Stöckl
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Correspondence to Stephan W. Aberle.

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Aberle, S.W., Aberle, J.H., Steininger, C. et al. Quantitative real time PCR detection of Varicella-zoster virus DNA in cerebrospinal fluid in patients with neurological disease. Med Microbiol Immunol 194, 7–12 (2005). https://doi.org/10.1007/s00430-003-0202-1

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  • DOI: https://doi.org/10.1007/s00430-003-0202-1

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