The predictive value of cerebrospinal fluid Epstein-Barr viral load as a marker of primary central nervous system lymphoma in HIV-infected persons
Date
2008
Authors
Corcoran C.
Rebe K.
van der Plas H.
Myer L.
Hardie D.R.
Journal Title
Journal ISSN
Volume Title
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Abstract
Background: The presence of Epstein-Barr virus (EBV) DNA in cerebrospinal fluid (CSF) is used as a marker of HIV-associated primary central nervous system lymphoma (PCNSL). In our setting, EBV DNA is frequently detected in the CSF of HIV-infected patients with miscellaneous neurological diseases and thus its presence is a poor predictor of PCNSL. Objectives: To determine whether quantification of EBV DNA in CSF improves its diagnostic specificity for PCNSL. Study design: EBV viral loads were determined on CSF samples from 55 HIV-infected patients with CNS disease. Results: Twenty of the 55 patients had detectable EBV DNA in their CSF (median viral load 6120 copies/ml, range 336-1,034,000 copies/ml). PCNSL was confirmed in 2 patients. Their CSF EBV loads were 1,034,000 and 15,460 copies/ml, respectively. Using a cut-off of 10,000 copies/ml improved the specificity and positive predictive value (PPV) compared to a qualitative result for the diagnosis of PCNSL (96% vs. 66% and 50% vs. 10%, respectively). Conclusion: EBV DNA is commonly detected in CSF of HIV-infected patients. Quantitative PCR improves the diagnostic specificity, however, the PPV remains too low for it to be used as an isolated marker for PCNSL. © 2008 Elsevier B.V. All rights reserved.
Description
Keywords
virus DNA, adult, article, CD4 lymphocyte count, cerebrospinal fluid cytology, controlled study, diagnostic accuracy, diagnostic value, disease marker, Epstein Barr virus, human, human cell, Human immunodeficiency virus infected patient, human tissue, major clinical study, neuroimaging, neurologic disease, polymerase chain reaction, prediction, primary central nervous system lymphoma, priority journal, quantitative assay, sensitivity and specificity, virus detection, virus load, Adult, Central Nervous System Neoplasms, Cerebrospinal Fluid, DNA, Viral, Herpesvirus 4, Human, HIV Infections, Humans, Lymphoma, Middle Aged, Predictive Value of Tests, Sensitivity and Specificity
Citation
Journal of Clinical Virology
42
4
42
4