DEVELOPMENT OF A REVERSE TRANSCRIPTION-POLYMERASE CHAIN-REACTION ASSAY FOR DIAGNOSIS OF LYMPHOCYTIC CHORIOMENINGITIS VIRUS-INFECTION AND ITS USE IN A PROSPECTIVE SURVEILLANCE STUDY

Lymphocytic choriomeningitis virus (LCMV), which is one of several are naviruses that are pathogenic for humans, causes encephalitis and meni ngitis in man. In this study, single-stage and nested reverse transcri ption-polymerase chain reaction (RT-PCR) assays were developed that ta rgeted the GPC and N genes of LCMV. Both assays detected <1 TCID50 uni t of LCMV. These assays were used to measure the incidence of LCMV inf ection by testing cerebrospinal fluid (CSF) samples with greater than or equal to 10 leukocytes/mu l collected over 1 year from patients und ergoing lumbar puncture for diagnostic reasons at two Birmingham hospi tals. Samples were tested for the presence of LCMV RNA by using the RT -PCR assay and for LCMV-specific IgM antibody by using an ELISA assay. None of the specimens collected from 813 patients was positive by eit her assay. Although no cases of acute infection were detected, 4% (11/ 272) of serum collected from a subset of patients was positive for LCM V-specific IgG. A significantly greater rate of seropositivity was fou nd among subjects over 60 years of age (9.4%; P < 0.025) than was foun d in younger subjects (2.4% at 30-59 years of age; 0% at <30 years of age). These data suggest that serious central nervous system disease d ue to LCMV infection is not common in this population. The high rate o f seropositivity in those over 60 years of age suggest that infection was once more common. (C) 1997 Wiley-Liss, Inc.