DETECTION OF CYTOMEGALOVIRUS DNA IN CEREBROSPINAL-FLUID IN IMMUNOCOMPETENT PATIENTS AS A SIGN OF ACTIVE INFECTION

Detection of cytomegalovirus (CMV) DNA by the polymerase chain reactio n (PCR) in samples of cerebrospinal fluid (CSF) has been shown to be a sensitive method of diagnosing CMV disease in the central nervous sys tem. Since CMV causes latent infection in white blood cells, an unansw ered question is whether detection of latent CMV DNA in the cell fract ion of CSF samples by PCR is possible in seropositive patients. In a p rospective study, the finding of CMV DNA in CSF of CMV seropositive pa tients with suspected viral infection of the central nervous system (C NS) was evaluated clinically. Fractionation of 64 CSF samples from ser opositive patients was carried out before analysing the samples for CM V DNA by PCR. In four of the five patients who had CMV DNA in the cell pellet and/or supernatant, the clinical data suggested CMV-associated neurological disease. The remaining 59 samples were negative in both pellet and supernatant. In addition, 11 CSF samples with high cell cou nts from patients with bacterial meningitis were examined for CMV DNA and found to be negative in 10 patients and positive in 1. One hundred thirty two uncentrifuged CSF samples were used as negative controls. The results of the study indicate that detection of CMV DNA in CSF sam ples by PCR correlated well with disease and was not due to latent CMV infection. (C) 1995 Wiley-Liss, Inc.