Frontiers in Medicine (Jan 2024)

Molecular diagnosis of opportunistic infections in the central nervous system of HIV-infected adults in Manaus, Amazonas

  • Sabrina Araújo de Melo,
  • Sérgio Damasceno Pinto,
  • Ewerton da Silva Ferreira,
  • Reinan Brotas,
  • Eveny Perlize Melo Marinho,
  • Valderjane Aprigio da Silva,
  • Rossiclea Lins Monte,
  • Pablo Vinícius Silveira Feitoza,
  • Monique Freire Reis,
  • Taynná V. Rocha Almeida,
  • Luiz Carlos de Lima Ferreira,
  • Michele de Souza Bastos

DOI
https://doi.org/10.3389/fmed.2023.1298435
Journal volume & issue
Vol. 10

Abstract

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BackgroundOpportunistic infections in the central nervous system (CNS) of people with HIV/AIDS (PLWHA) remain significant contributors to morbidity and mortality, especially in resource-limited scenarios. Diagnosing these infections can be challenging, as brain imaging is non-specific and expensive. Therefore, molecular analysis of cerebrospinal fluid (CSF) may offer a more accurate and affordable method for diagnosing pathogens.MethodsWe conducted extensive real-time PCR testing (qPCR) on CSF to evaluate etiological agents in PLWHA with neurological manifestations. Primers targeting DNA from specific pathogens, including cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein–Barr virus (EBV), John Cunningham virus (JCV), Toxoplasma gondii, and human T-lymphotropic virus types 1 and 2 (HTLV-1 and HTLV-2), were used.ResultsCerebrospinal fluid samples revealed 90 pathogens (36.7%). Toxoplasma gondii was the most frequently detected pathogen, found in 22 samples (30.5%). Other pathogens included Cryptococcus sp. (7.7%), EBV (5.3%), CMV, VZV, and JCV (4.0% each).ConclusionDespite antiretroviral therapy and medical follow-up, opportunistic central nervous system infections remain frequent in PLWHA. Herpesviruses are commonly detected, but T. gondii is the most prevalent opportunistic pathogen in our study population. Therefore, molecular diagnosis is a crucial tool for identifying opportunistic infections, even in patients undergoing treatment.

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