title: The effect of highly active antiretroviral therapy on outcome of central nervous system herpesviruses infection in Cuban human immunodeficiency virus-infected individuals.
abstract: With the rapid progress in the development of highly active antiretroviral therapy (HAART), the observed patterns in human immunodeficiency virus (HIV) encephalitis has changed, allowing herpesvirus (HV) infection to be controlled. HAART was first administered to HIV patients in Cuba in 2001. Consequently with the aim of investigate the behavior of the HVs causing neurological disorders in this population in the post-HAART era, the authors perform a clinical evaluation by a multiplex nested polymerase chain reaction (PCR) assay for simultaneous detection of human HVs--herpes simplex virus (HSV), varicella-zoster virus (VZV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), and Epstein-Barr virus (EBV). The authors studied 241 samples of cerebrospinal fluid (CSF) received at the Sexually Transmitted Diseases Laboratory between 2001 and 2005 inclusive. Of the 241 CSF studied, 10.4% resulted positive for HV infections. Of these, 92% of patients were acquired immunodeficiency syndrome (AIDS) individuals at the C3 stage. CMV (44%), EBV (28%), and dual-HV (16%) infections were the most important agents identified. The principal clinical manifestations were fever, headache, vomiting, and focal abnormalities; the latter being associated with an increased risk of death. A statistically significant result was observed when central nervous system (CNS) disease evolution was compared between patients who were under HAART against those who were not, before they developed encephalitis. It was therefore concluded that it is more likely that HIV individuals receiving HAART have a better recovery of CNS infections than those who are not receiving it.
authors.affiliation: Virology Department, Institute of Tropical Medicine Pedro Kourí (IPK), Marianao 13, Ciudad Habana, Cuba.
authors.forename: Pedro Ariel
authors.initials: PA
authors.lastname: Martínez
authors.forename: René
authors.initials: R
authors.lastname: Díaz
authors.forename: Daniel
authors.initials: D
authors.lastname: González
authors.forename: Lisset
authors.initials: L
authors.lastname: Oropesa
authors.forename: Ruby
authors.initials: R
authors.lastname: González
authors.forename: Lissette
authors.initials: L
authors.lastname: Pérez
authors.forename: Jenniffer
authors.initials: J
authors.lastname: Viera
authors.forename: Vivian
authors.initials: V
authors.lastname: Kourí
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D002493:Central Nervous System Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology*; D003462:Cuba / Q000453:epidemiology; D003586:Cytomegalovirus Infections / Q000188:drug therapy; D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification; D006566:Herpesviridae Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000235:genetics; D018259:Herpesvirus 1, Human; D018258:Herpesvirus 2, Human; D015654:Herpesvirus 6, Human; D006801:Humans; D016017:Odds Ratio; D016133:Polymerase Chain Reaction
chemical_list: D004279:DNA, Viral