Epstein-barr virus coinfection in cerebrospinal fluid is associated with increased mortality in Malawian adults with bacterial meningitis.

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Kelly, Matthew J. ; Benjamin, Laura A. ; Cartwright, Katharine ; Ajdukiewicz, Katherine M.B. ; Cohen, Danielle B. ; Menyere, Mavis ; Galbraith, Sareen ; Guiver, Malcolm ; Neuhann, Florian ; Solomon, Tom ; Lalloo, David ; Heyderman, Robert S. (2012)
  • Publisher: Oxford University Press
  • Journal: The Journal of Infectious Diseases, volume 205, issue 1, pages 106-110 (issn: 0022-1899, eissn: 1537-6613)
  • Related identifiers: pmc: PMC3242746, doi: 10.1093/infdis/jir707
  • Subject: wc_571 | wl_200 | HIV/AIDS | qw_160 | Major Articles and Brief Reports | wc_245
    mesheuropmc: viruses | virus diseases

Mortality from adult bacterial meningitis exceeds 50% in sub-Saharan Africa. We postulated that—particularly in individuals infected with human immunodeficiency virus (HIV)—herpes simplex virus, varicella zoster virus, Epstein-Barr virus (EBV), and cytomegalovirus (CMV) in the cerebrospinal fluid (CSF) contribute to poor outcome. CSF from 149 Malawian adults with bacterial meningitis and 39 controls were analyzed using polymerase chain reaction. EBV was detected in 79 of 149 bacterial meningitis patients. Mortality (54%) was associated with higher CSF EBV load when adjusted for HIV (P = .01). CMV was detected in 11 of 115 HIV-infected patients, 8 of whom died. The mechanisms by which EBV and CMV contribute to poor outcome require further investigation.
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