SidaSubSaharaV1, Main, Exploration, bibRecord, 002075

Molecular Diagnosis of Central Nervous System Opportunistic Infections in HIV-Infected Zambian Adults

Identifieur interne : 002075 ( Main/Exploration ); précédent : 002074; suivant : 002076

Molecular Diagnosis of Central Nervous System Opportunistic Infections in HIV-Infected Zambian Adults

Auteurs : Omar K. Siddiqi [États-Unis, Zambie] ; Musie Ghebremichael [États-Unis] ; XIN DANG [États-Unis] ; Masharip Atadzhanov [Zambie] ; Patrick Kaonga [Zambie] ; Michael N. Khoury [États-Unis] ; Igor J. Koralnik [États-Unis]

Source :

Clinical infectious diseases [ 1058-4838 ] ; 2014.

RBID : Pascal:14-0162492

Descripteurs français

Pascal (Inist)
- SIDA, Diagnostic, Système nerveux central, Infection opportuniste, Zambie, Adulte.
Wicri :
- geographic : Zambie.
- topic : Adulte.

English descriptors

KwdEn :
- AIDS, Adult, Central nervous system, Diagnosis, Opportunistic infection, Zambia.

Abstract

Background. Knowledge of central nervous system (CNS) opportunistic infections (OIs) among people living with human immunodeficiency virus (HIV) in sub-Saharan Africa is limited. Methods. We analyzed 1 cerebrospinal fluid (CSF) sample from each of 331 HIV-infected adults with symptoms suggestive of CNS OI at a tertiary care center in Zambia. We used pathogen-specific primers to detect DNA from JC virus (JCV), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV) types 1 and 2, Mycobacterium tuberculosis, and Toxoplasma gondii via real-time polymerase chain reaction (PCR). Results. The patients' median CD4⁺ T-cell count was 89 cells/μL (interquartile range, 38-191 cells/μL). Of 331 CSF samples, 189 (57.1%) had at least 1 pathogen. PCR detected DNA from EBV in 91 (27.5%) patients, M. tuberculosis in 48 (14.5%), JCV in 20 (6.0%), CMV in 20 (6.0%), VZV in 13 (3.9%), HSV-1 in 5 (1.5%), and HSV-2 and T. gondii in none. Fungal and bacteriological studies showed Cryptococcus in 64 (19.5%) patients, pneumococcus in 8 (2.4%), and meningococcus in 2 (0.6%). Multiple pathogens were found in 68 of 189 (36.0%) samples. One hundred seventeen of 331 (35.3%) inpatients died during their hospitalization. Men were older than women (median, 37 vs 34 years; P = .01), more recently diagnosed with HIV (median, 30 vs 63 days; P = .03), and tended to have a higher mortality rate (40.2% vs 30.2%; P=.07). Conclusions. CNS OIs are frequent, potentially treatable complications of AIDS in Zambia. Multiple pathogens often coexist in CSF. EBV is the most prevalent CNS organism in isolation and in coinfection. Whether it is associated with CNS disease or a marker of inflammation requires further investigation. More comprehensive testing for CNS pathogens could improve treatment and patient outcomes in Zambia.

Affiliations:

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Le document en format XML

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<author><name sortKey="Atadzhanov, Masharip" sort="Atadzhanov, Masharip" uniqKey="Atadzhanov M" first="Masharip" last="Atadzhanov">Masharip Atadzhanov</name>
<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Internal Medicine, University of Zambia School of Medicine</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
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<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Internal Medicine, University of Zambia School of Medicine</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>1 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
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<country>Zambie</country>
<wicri:noRegion>Lusaka</wicri:noRegion>
</affiliation>
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<author><name sortKey="Khoury, Michael N" sort="Khoury, Michael N" uniqKey="Khoury M" first="Michael N." last="Khoury">Michael N. Khoury</name>
<affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Division of Neuro-Virology, Beth Israel Deaconess Medical Center</s1>
<s2>Boston, Massachusetts</s2>
<s3>USA</s3>
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<placeName><region type="state">Massachusetts</region>
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<author><name sortKey="Koralnik, Igor J" sort="Koralnik, Igor J" uniqKey="Koralnik I" first="Igor J." last="Koralnik">Igor J. Koralnik</name>
<affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Division of Neuro-Virology, Beth Israel Deaconess Medical Center</s1>
<s2>Boston, Massachusetts</s2>
<s3>USA</s3>
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<placeName><region type="state">Massachusetts</region>
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<series><title level="j" type="main">Clinical infectious diseases</title>
<title level="j" type="abbreviated">Clin. infect. dis.</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS</term>
<term>Adult</term>
<term>Central nervous system</term>
<term>Diagnosis</term>
<term>Opportunistic infection</term>
<term>Zambia</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>SIDA</term>
<term>Diagnostic</term>
<term>Système nerveux central</term>
<term>Infection opportuniste</term>
<term>Zambie</term>
<term>Adulte</term>
</keywords>
<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Zambie</term>
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<front><div type="abstract" xml:lang="en">Background. Knowledge of central nervous system (CNS) opportunistic infections (OIs) among people living with human immunodeficiency virus (HIV) in sub-Saharan Africa is limited. Methods. We analyzed 1 cerebrospinal fluid (CSF) sample from each of 331 HIV-infected adults with symptoms suggestive of CNS OI at a tertiary care center in Zambia. We used pathogen-specific primers to detect DNA from JC virus (JCV), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV) types 1 and 2, Mycobacterium tuberculosis, and Toxoplasma gondii via real-time polymerase chain reaction (PCR). Results. The patients' median CD4<sup>+</sup>
 T-cell count was 89 cells/μL (interquartile range, 38-191 cells/μL). Of 331 CSF samples, 189 (57.1%) had at least 1 pathogen. PCR detected DNA from EBV in 91 (27.5%) patients, M. tuberculosis in 48 (14.5%), JCV in 20 (6.0%), CMV in 20 (6.0%), VZV in 13 (3.9%), HSV-1 in 5 (1.5%), and HSV-2 and T. gondii in none. Fungal and bacteriological studies showed Cryptococcus in 64 (19.5%) patients, pneumococcus in 8 (2.4%), and meningococcus in 2 (0.6%). Multiple pathogens were found in 68 of 189 (36.0%) samples. One hundred seventeen of 331 (35.3%) inpatients died during their hospitalization. Men were older than women (median, 37 vs 34 years; P = .01), more recently diagnosed with HIV (median, 30 vs 63 days; P = .03), and tended to have a higher mortality rate (40.2% vs 30.2%; P=.07). Conclusions. CNS OIs are frequent, potentially treatable complications of AIDS in Zambia. Multiple pathogens often coexist in CSF. EBV is the most prevalent CNS organism in isolation and in coinfection. Whether it is associated with CNS disease or a marker of inflammation requires further investigation. More comprehensive testing for CNS pathogens could improve treatment and patient outcomes in Zambia.</div>
</front>
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<affiliations><list><country><li>Zambie</li>
<li>États-Unis</li>
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<name sortKey="Ghebremichael, Musie" sort="Ghebremichael, Musie" uniqKey="Ghebremichael M" first="Musie" last="Ghebremichael">Musie Ghebremichael</name>
<name sortKey="Khoury, Michael N" sort="Khoury, Michael N" uniqKey="Khoury M" first="Michael N." last="Khoury">Michael N. Khoury</name>
<name sortKey="Koralnik, Igor J" sort="Koralnik, Igor J" uniqKey="Koralnik I" first="Igor J." last="Koralnik">Igor J. Koralnik</name>
<name sortKey="Xin Dang" sort="Xin Dang" uniqKey="Xin Dang" last="Xin Dang">XIN DANG</name>
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<country name="Zambie"><noRegion><name sortKey="Siddiqi, Omar K" sort="Siddiqi, Omar K" uniqKey="Siddiqi O" first="Omar K." last="Siddiqi">Omar K. Siddiqi</name>
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	Le SIDA en Afrique subsaharienne (serveur d'exploration)
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Le SIDA en Afrique subsaharienne (serveur d'exploration)

Molecular Diagnosis of Central Nervous System Opportunistic Infections in HIV-Infected Zambian Adults

Molecular Diagnosis of Central Nervous System Opportunistic Infections in HIV-Infected Zambian Adults

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri