title: Epstein-Barr viral load in cerebrospinal fluid as a diagnostic marker of central nervous system involvement of AIDS-related lymphoma.
abstract: OBJECTIVE
  AIDS-related lymphoma (ARL) often involves the central nervous system (CNS). Although the diagnostic value of Epstein-Barr virus (EBV)-DNA in cerebrospinal fluid (CSF) in detecting HIV-positive primary CNS lymphoma (PCNSL) has been established, its usefulness for identifying CNS involvement of systemic ARL remains elusive. In this study, we evaluated the utility of the EBV-DNA load in CSF in identifying CNS involvement in patients with systemic ARL.
  
  
  METHODS
  We retrospectively reviewed the clinical and pathological data of consecutive ARL patients managed at our clinic between January 1998 and June 2012. Sixty-two patients with ARL, including eight PCNSL patients and 52 systemic ARL patients, and 63 controls underwent CSF EBV-DNA load evaluations before receiving chemotherapy. ARL-related CNS involvement was defined as any lesion diagnosed histologically or radiologically as a lymphoma in the brain, meninges, spine, cranial nerves or oculus.
  
  
  RESULTS
  A cut off value of 200 copies/mL predicted the presence of CNS lesions with a sensitivity of 70% and a specificity of 85% in both the PCNSL and systemic ARL patients, while a sensitivity of 75% and a specificity of 93% were obtained for systemic ARL. A cut off value of 2,000 (3.30 log) copies/mL provided the best specificity (100%), with a sensitivity of 50%.
  
  
  CONCLUSIONS
  Our results support the clinical utility of evaluating the quantitative EBV-DNA load in the CSF for the diagnosis of CNS involvement of systemic ARL as well as PCNSL.
authors: Department of Medicine and Clinical Science, Graduate School of Medicine, Gunma University, Japan.
authors: Kunio
authors: K
authors: Yanagisawa
authors: Junko
authors: J
authors: Tanuma
authors: Shotaro
authors: S
authors: Hagiwara
authors: Hiroyuki
authors: H
authors: Gatanaga
authors: Yoshimi
authors: Y
authors: Kikuchi
authors: Shinichi
authors: S
authors: Oka
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000097:blood / Q000134:cerebrospinal fluid / Q000737:chemistry / Q000821:virology*; D002555:Cerebrospinal Fluid / Q000821:virology; D004279:DNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid; D020031:Epstein-Barr Virus Infections / Q000097:blood / Q000134:cerebrospinal fluid*; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification* / Q000472:pathogenicity; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000097:blood / Q000134:cerebrospinal fluid / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D004279:DNA, Viral; C099537:Epstein-Barr virus encoded RNA 1; C106732:Epstein-Barr virus encoded RNA 2; D012367:RNA, Viral