MOLECULAR EVIDENCE AND CLINICAL-SIGNIFICANCE OF HERPESVIRUS COINFECTION IN THE CENTRAL-NERVOUS-SYSTEM

A total of 60 cerebrospinal fluid (CSF) specimens from patients manife sting symptoms resembling viral central nervous system (CNS) disease w ere examined for the presence of herpes simplex virus (HSV), human her pesvirus 6 (HHV-6), Epstein-Barr virus (EBV), cytomegalovirus, varicel la-zoster virus, Borrelia burgdorferi, and Tropheryma whippelii DNA by PCR, Of 30 specimens which were selected on the basis of HSV DNA posi tivity, 2 were concomitantly positive for HHV-6 DNA and 1 was positive for EBV DNA. In the three specimens positive for more than one herpes virus, amplicons generated with virus-specific primer sets hybridized specifically to the corresponding virus-specific probe, Sequence analy sis of the two amplified DNA fragments demonstrated that they were der ived from distinct herpesviruses, Of 22 patients with clinically diagn osed encephalitis, 2 of 3 patients coinfected with HSV and HHV-6 died, compared to 1 of 19 (5%) patients infected with only HSV, Of 30 CSF s pecimens that were negative for HSV DNA, EBV DNA was detected in one s ample, These data indicated the presence of DNA specific for two disti nct herpesviruses in the same CSF specimen, providing molecular eviden ce that coinfection with this group of viruses may occur in the CNS.