Clinical features associated with cerebrospinal fluid Epstein-Barr virus positivity in autoimmune GFAP astrocytopathy: a multicenter retrospective cohort study.

Xing Mao, Qianqian Qu, Chao Quan, Haidong Lyu, Jingzi Zhangbao, Xuan Wang, Hongmei Tan, Xiang Li

Abstract readMulticenter StudyObservational Study

In one paragraph

Observational study in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Xing MaoDepartment of Neurology, Jiaozuo People's Hospital, Jiaozuo, China.

Qianqian QuDepartment of Neurology, Jiaozuo People's Hospital, Jiaozuo, China.

Chao QuanDepartment of Neurology, Huashan Hospital, Fudan University, Shanghai, China.

Haidong LyuDepartment of Neurology, Jiaozuo People's Hospital, Jiaozuo, China.

Jingzi ZhangbaoDepartment of Neurology, Huashan Hospital, Fudan University, Shanghai, China.

Xuan WangDepartment of Infectious Diseases, Huashan Hospital Fudan University, Shanghai, China.

Hongmei TanDepartment of Neurology, Huashan Hospital, Fudan University, Shanghai, China.

Xiang LiDepartment of Neurology, Huashan Hospital, Fudan University, Shanghai, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Autoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A) is an inflammatory disorder of the central nervous system. The clinical implications of Epstein-Barr virus (EBV) sequences detected in cerebrospinal fluid (CSF) by metagenomic next-generation sequencing (mNGS) remain uncertain. Methods: This multicenter retrospective cohort study enrolled 60 patients with GFAP-A screened from electronic medical records of two hospitals (Jan 2019-Dec 2025). Patients were stratified into CSF EBV-positive ( Results: CSF WBC count was higher in the CSF EBV-positive group than in the CSF EBV-negative group [median, 120 (interquartile range, 105-220) vs. 33 (16-97) × 10⁶/L; raw Conclusion: CSF WBC count was the only clinically prioritized comparison that remained statistically significant after Bonferroni correction, suggesting greater CSF pleocytosis and possibly increased intrathecal inflammatory activity in GFAP-A patients with mNGS-detectable CSF EBV. Differences in altered consciousness and CSF chloride remained inconclusive after multiplicity adjustment. Within the EBV-positive subgroup, raw EBV sequencing reads showed no correlation with inflammatory or disability measures. Current findings do not establish CSF EBV positivity as an independent pathogenic or prognostic biomarker for GFAP-A, and the biological origin of the detected EBV sequences remains uncertain.

Indexed as

AstrocytesAutoimmune Diseases of the Nervous SystemEpstein-Barr Virus InfectionsGlial Fibrillary Acidic ProteinHerpesvirus 4, HumanAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesGFAP protein, humanGlial Fibrillary Acidic Proteinautoimmune GFAP astrocytopathycerebrospinal fluidEpstein–Barr virusmetagenomic next-generation sequencingneuroinflammationprognosis

Identifiers

PMID42723798

DOI10.3389/fneur.2026.1906448

PMCPMC13557978

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