Epstein-Barr virus and human herpesvirus type 8 infections of the central nervous system

Herpes. 2004 Jun:11 Suppl 2:120A-127A.

Abstract

In developing guidelines for the improved management of herpesvirus infections of the central nervous system (CNS), the International Herpes Management Forum (IHMF) has studied Epstein-Barr virus (EBV) and human herpesvirus type 8 (HHV-8)- related diseases. EBV has been associated with numerous CNS diseases including meningitis, encephalitis and post transplant lymphoproliferative disorder (PTLD). The pathogenesis of EBV-associated CNS disorders is not completely understood but may be due to direct virus invasion of the CNS. Alternatively, damage may be immunologically mediated by infiltration of cytotoxic CD8+ lymphocytes into neural tissue or deposition of antibody-antigen complexes. The IHMF recommends that diagnosis of EBV infections of the CNS may involve polymerase chain reaction (PCR) of cerebrospinal fluid (CSF) for EBV DNA but the sensitivity and specificity of the technique remains to be determined. Furthermore, the value of PCR in this context may be limited as EBV DNA is often detected in patients without neurological symptoms. Antiviral therapy has not demonstrated clinical efficacy in the treatment of EBV-related CNS disorders. CNS complications of HHV-8 infection are rare, but the virus has been associated with AIDS-dementia complex, amyotrophic lateral sclerosis (ALS) and primary CNS lymphoma; however these links remain to be proven.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • Central Nervous System Viral Diseases / cerebrospinal fluid
  • Central Nervous System Viral Diseases / diagnosis*
  • Central Nervous System Viral Diseases / drug therapy
  • Central Nervous System Viral Diseases / pathology
  • Epstein-Barr Virus Infections / cerebrospinal fluid
  • Epstein-Barr Virus Infections / diagnosis*
  • Epstein-Barr Virus Infections / drug therapy
  • Epstein-Barr Virus Infections / pathology
  • Herpesviridae Infections / cerebrospinal fluid
  • Herpesviridae Infections / diagnosis*
  • Herpesviridae Infections / drug therapy
  • Herpesviridae Infections / pathology
  • Herpesvirus 4, Human / isolation & purification*
  • Herpesvirus 8, Human / isolation & purification*
  • Humans
  • Practice Guidelines as Topic

Substances

  • Antiviral Agents