title: A comparison of brain biopsy and CSF-PCR in the diagnosis of CNS lesions in AIDS patients.
abstract: Twenty patients with AIDS who had intracranial lesions underwent both brain biopsy and cerebrospinal fluid (CSF) examination to compare histological diagnosis with the polymerase chain reaction (CSF-PCR) for the identification of infectious agents. CSF-PCR was performed for herpes simplex virus, varicella zoster virus, cytomegalovirus (CMV), JC virus (JCV), Epstein-Barr virus (EBV), Toxoplasma gondii and Mycobacterium tuberculosis. A definitive diagnosis was obtained by brain biopsy in 14 patients (2 with astrocytoma, 12 with brain infection). CSF-PCR was positive for EBV DNA in 3 of 3 cases of primary cerebral lymphoma, positive for JCV DNA in 6 of 7 biopsy-proven (and one autopsy-proven) cases of progressive multifocal leukoencephalopathy (PML). CSF-PCR was positive for CMV DNA in one biopsy-proven and one autopsy-proven case of CMV encephalitis (the former also had PML) and positive for M. tuberculosis DNA in one case of tuberculous encephalitis. None of the five toxoplasmic encephalitis cases (one definite, four presumptive) were T. gondii DNA positive. There was close correlation between histology and CSF-PCR for CMV encephalitis, PML and PCL. Antitoxoplasma therapy affected the sensitivity of both histological and CSF-PCR methods.
authors.affiliation: Infectious Diseases Clinic, L Sacco Hospital, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: d'Arminio Monforte
authors.forename: P
authors.initials: P
authors.lastname: Cinque
authors.forename: L
authors.initials: L
authors.lastname: Vago
authors.forename: A
authors.initials: A
authors.lastname: Rocca
authors.forename: A
authors.initials: A
authors.lastname: Castagna
authors.forename: C
authors.initials: C
authors.lastname: Gervasoni
authors.forename: M R
authors.initials: MR
authors.lastname: Terreni
authors.forename: R
authors.initials: R
authors.lastname: Novati
authors.forename: A
authors.initials: A
authors.lastname: Gori
authors.forename: A
authors.initials: A
authors.lastname: Lazzarin
authors.forename: M
authors.initials: M
authors.lastname: Moroni
mesh_terms: D015526:AIDS Dementia Complex / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000401:mortality; D000328:Adult; D000818:Animals; D001706:Biopsy; D001921:Brain / Q000473:pathology*; D002555:Cerebrospinal Fluid / Q000382:microbiology*; D003587:Cytomegalovirus / Q000302:isolation & purification; D004279:DNA, Viral / Q000032:analysis; D004660:Encephalitis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D014645:Herpesvirus 3, Human / Q000302:isolation & purification; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018139:Simplexvirus / Q000302:isolation & purification; D015996:Survival Rate; D014122:Toxoplasma / Q000302:isolation & purification
chemical_list: D004279:DNA, Viral