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Characterizing Epstein-Barr virus infection of the central nervous system in Zambian adults living with HIV

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Abstract

The significance of Epstein-Barr virus (EBV) detection in the cerebrospinal spinal fluid (CSF) in people living with HIV (PLWH) is not entirely understood. The detection of EBV DNA may represent active central nervous system (CNS) infection, reactivation in the setting of another CNS pathogen or due to impaired immunity, or detection of quiescent virus. We screened 470 adult PLWH in Zambia with neurological symptoms for the presence of EBV DNA in the CSF. We performed quantitative EBV PCR on the CSF and blood. We then performed quantitative EBV DNA PCR on the blood of controls with documented HIV viral suppression without CNS symptoms. The prevalence of EBV DNA in the CSF of patients with CNS symptoms was 28.9% (136/470). EBV DNA positivity was associated with younger age, shorter duration of HIV diagnosis, lower CSF glucose levels, higher CSF protein and white blood cell levels, and a positive CSF Mycobacterium tuberculosis result. The median EBV DNA load was 8000 cps/mL in both the CSF and blood with a range of 2000–2,753,000 cps/mL in the CSF and 1000 to 1,871,000 cps/mL in the blood. Molecular screening of CSF for other possible causes of infection identified Mycobacterium tuberculosis in 30.1% and cytomegalovirus (CMV) in 10.5% of samples. EBV DNA load in the blood and CSF was not associated with mortality. Our results suggest that even though EBV DNA was commonly detected in the CSF of our population, it appears to have limited clinical significance regardless of EBV DNA load.

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Data availability

Data will be made available to any interested researchers upon request. To request data access, one must write to the corresponding author, Ms. Kalo Musukuma-Chifulo (kalomusukuma@gmail.com), mentioning the intended use of the data. The corresponding author will then facilitate express authorization to release the data as requested. Dataset requests must include contact information, a research project title, a description of the proposed analysis, and the expected format. The requested data should only be used for purposes related to the original research or study. All data requests will be reviewed within 48 – 72 hours (Monday - Friday), and notification if access has been granted or additional project information is needed before access can be granted.

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Funding

This work was supported in part by the following grants: NIH K23 NS 084054 awarded to O.K.S, Harvard University Center for AIDS Research (HU CFAR NIH/NAIDS P30-AI 060354), and the Ragon Institute of Mass General, MIT and Harvard awarded to I.K, European and Developing Countries Clinical Trials Partnership (EDCTP2) programme under the PANDORA-ID-NET Consortium (EDCTP Reg/Grant RIA2016E-1609).

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Authors and Affiliations

  1. Department of Biomedical Sciences, School of Health Sciences, The University of Zambia, Lusaka, Zambia

    Kalo Musukuma-Chifulo & Sody Munsaka

  2. Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia

    Kalo Musukuma-Chifulo, Obvious Nchimunya Chilyabanyama, Michelo Simuyandi & Caroline Chisenga

  3. Harvard Medical School and Ragon Institute of Mass General, MIT and Harvard, Boston, MA, USA

    Musie Ghebremichael

  4. HerpeZ, University Teaching Hospital, Lusaka, Zambia

    Matthew Bates & John Tembo

  5. School of Life & Environmental Sciences, University of Lincoln, Lincoln, UK

    Matthew Bates

  6. Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia

    Edford Sinkala & Omar K. Siddiqi

  7. Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA

    Igor J. Koralnik & Xin Dang

  8. Zambia National Public Health Institute, Ministry of Health, 10101, Lusaka, Zambia

    Roma Chilengi

  9. Global Neurology Program, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Omar K. Siddiqi

  10. Center for Vaccines and Virology Research, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Omar K. Siddiqi

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  1. Kalo Musukuma-Chifulo
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  2. Musie Ghebremichael
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  8. John Tembo
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  9. Edford Sinkala
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  11. Xin Dang
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  12. Roma Chilengi
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  13. Omar K. Siddiqi
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Correspondence to Kalo Musukuma-Chifulo.

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Musukuma-Chifulo, K., Ghebremichael, M., Chilyabanyama, O.N. et al. Characterizing Epstein-Barr virus infection of the central nervous system in Zambian adults living with HIV. J. Neurovirol. 29, 706–712 (2023). https://doi.org/10.1007/s13365-023-01178-4

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  • DOI: https://doi.org/10.1007/s13365-023-01178-4

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