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

Matthew J. Kelly*, Laura A. Benjamin, Katharine Cartwright, Katherine M.B. Ajdukiewicz, Danielle B. Cohen, Mavis Menyere, Sareen Galbraith, Malcolm Guiver, Florian Neuhann, Tom Solomon, David G. Lalloo, Robert S. Heyderman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

39 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)106-110
Number of pages5
JournalJournal of Infectious Diseases
Volume205
Issue number1
DOIs
Publication statusPublished - 1 Jan 2012
Externally publishedYes

Bibliographical note

Funding Information:
Acknowledgments. The authors thank Sarah White for her assistance with the statistical analysis. Financial support. This work was supported by grants from the Meningitis Research Foundation (0905.0) and the Wellcome Trust (084679/Z/08/Z), United Kingdom. Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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