The current study aimed to investigate whether cerebrospinal fluid (CSF) Epstein–Barr virus
(EBV) or cytomegalovirus (CMV) DNA was associated with viral, inflammatory and neuronal damage biomarkers
in people living with HIV
A cross-sectional diagnostic study on CSF fluid samples in patients undergoing lumbar punctures for clinical reasons, to better understand the role of EBV and CMV in the CNS on HIV
RNA replication, blood-brain-barrier (BBB) damage and biomarkers
of neuronal damage/inflammation.
EBV, CMV DNA and HIV
RNA were measured on CSF, through real time (RT)-PCR, from PLWHs undergoing lumbar punctures for clinical reasons (excluding oncho-haematological comorbidities). Immune-enzymatic assays evaluated blood–brain barrier
inflammation and damage. Patients were stratified according to plasma HIV
RNA levels in viremic (≥50 copies/ml) and aviremic (<50 copies/ml).
We included 297 participants. Among 167 viremic patients CSF EBV and CMV DNA were detectable in 42 (25.1%) and 10 (6.3%) participants; among 130 aviremic individuals CSF EBV and CMV DNA were detectable in 12 (9.2%) and 0 (0%) participants, respectively. In viremic group detectable CSF EBV DNA was associated with CSF pleocytosis (P
< 0.001), higher CSF HIV
< 0.001) and neopterin levels (P
= 0.002). In aviremic participants detectable EBV DNA was associated with pleocytosis (P
= 0.056), higher neopterin (P
= 0.027) and immune globulins (P
= 0.016) in the CSF; CSF escape was more common in those with detectable EBV DNA (50 vs. 21.2%, P
EBV DNA was frequently detected in the CSF of viremic and fewer aviremic patients on antiretroviral treatment. In PLWH without clinical evidence of encephalitis CSF EBV DNA was associated with higher biomarkers
levels of neuronal damage/inflammation. The role of EBV reactivation in HIV
-associated central nervous system
disorders warrants further studies.