ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2014
Molecular diagnosis of central nervous system opportunistic infections in HIV-infected Zambian adults.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.
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Who cites it
49 citing papers in PubMed, 2 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- Mortality from HIV-associated meningitis in sub-Saharan Africa: a systematic review and meta-analysis.Journal of the International AIDS Society · 2020Pooled it
- Varicella zoster virus-associated morbidity and mortality in Africa - a systematic review.BMC infectious diseases · 2017Pooled it
- Minimally Invasive Tissue Sampling for Postmortem Diagnosis of Tuberculous Meningitis in Zambian Adults.Open forum infectious diseases · 2026Article
- Metagenomic next-generation sequencing of cerebrospinal fluid reveals pathogen spectrum and mortality predictors among patients with advanced HIV-1 disease at a tertiary hospital in China.Virology journal · 2026Article
- Trends and patterns of varicella zoster virus infection in Kilifi: A population-based serosurvey.PLOS global public health · 2026Article
- Neurological Infections in HIV: A Case-Based Review for Clinicians.Le infezioni in medicina · 2026Review
- Epstein-Barr Virus Central Nervous System Infections and Mortality Risk in Patients Presenting With Suspected Meningitis: Results From the Botswana National Meningitis Survey and the Harare Meningitis Aetiology Study.Open forum infectious diseases · 2025Article
- Unveiling the Impact of Human Herpesviruses-Associated on CNS Infections: An Observational Study.Viruses · 2024Observational
- Characterizing Epstein-Barr virus infection of the central nervous system in Zambian adults living with HIV.Journal of neurovirology · 2023Article
- [Clinical significance of Epstein-Barr Virus detection in the cerebrospinal fluid of patients who underwent hematopoietic stem cell transplantation].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2023Article
- Patient, Provider, and Health Systems Factors Leading to Lumbar Puncture Nonperformance in Zambia: A Qualitative Investigation of the "Tap Gap".The American journal of tropical medicine and hygiene · 2023Article
- Metagenomic next-generation sequencing versus traditional laboratory methods for the diagnosis of central nervous system opportunistic infections in HIV-infected Chinese adults.Scientific reports · 2023Article
- Cerebral toxoplasmosis with neurological co-infection in people living with AIDS/HIV: results of a prospective cohort in São Paulo, Brazil.Arquivos de neuro-psiquiatria · 2023Observational
- Molecular diagnosis of opportunistic infections in the central nervous system of HIV-infected adults in Manaus, Amazonas.Frontiers in medicine · 2023Article
- Searching for new antifungals for the treatment of cryptococcosis.Revista da Sociedade Brasileira de Medicina Tropical · 2023Review
- Clinical presentation and outcomes of syphilitic meningitis among hospitalized adults in lusaka, Zambia.International journal of STD & AIDS · 2022Article
- Rapidly progressive dementia in an elderly man.Practical neurology · 2022Article
- Epstein-Barr Virus Detection in the Central Nervous System of HIV-Infected Patients.Pathogens (Basel, Switzerland) · 2022Review
- Optimization of cerebrospinal fluid microbial DNA metagenomic sequencing diagnostics.Scientific reports · 2022Article
- Early Antiretroviral Therapy in AIDS Patients Presenting WithFrontiers in medicine · 2022Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundKnowledge of central nervous system (CNS) opportunistic infections (OIs) among people living with human immunodeficiency virus (HIV) in sub-Saharan Africa is limited.
methodsWe 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).
resultsThe 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).
conclusionsCNS 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.
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