DETECTION OF EPSTEIN-BARR-VIRUS DNA IN CEREBROSPINAL-FLUID FOR DIAGNOSIS OF AIDS-RELATED CENTRAL-NERVOUS-SYSTEM LYMPHOMA

The diagnostic utility of Epstein-Barr virus (EBV) DNA detection in ce rebrospinal fluid for the diagnosis of central nervous system lymphoma was evaluated with two different PCR assays to test a collection of c erebrospinal fluid samples from 24 AIDS patients with central nervous system disorders, A PCR assay amplifying a fragment from the BamHI-W r egion had the highest clinical and analytic sensitivity. The BamHI-W P CR assay detected EBV DNA in cerebrospinal fluid from 83% (5 of 6) of patients with pathologically proven primary central nervous system lym phoma and 7% (1 of 16) of controls with autopsy-proven nonlymphomatous central nervous system disorders. EBV DNA was also detected in one pa tient with autopsy-proven systemic lymphoma involving the central nerv ous system and one patient with probable primary central nervous syste m lymphoma. EBV DNA was detected consistently when central nervous sys tem lymphoma involved meningeal surfaces. PCR for EBV in cerebrospinal fluid appears to be useful for diagnosis of AIDS-related central nerv ous system lymphoma, but additional studies are required to better def ine the sensitivity of the assay and to understand the significance of a positive test in the absence of lymphoma.