Clinical features and risk factors for Epstein-Barr virus-associated encephalitis: a retrospective cohort study.

IF 4 3区医学 Q2 VIROLOGY

Virology Journal Pub Date : 2025-05-13 DOI:10.1186/s12985-025-02768-w

Zhu Liu, Anjiao Peng, Luyan Huang, Leihao Sha, Yusha Tang, Yongzhao Zhou, Lei Chen

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引用次数: 0

Abstract

Background: Epstein-Barr virus (EBV) has been gradually recognized as an important pathogen of encephalitis, but our knowledge of EBV-associated encephalitis is still limited. The aim of this study was to describe the clinical features and explore the risk factors for EBV-associated encephalitis in a large cohort of Chinese patients.

Methods: All patients with confirmed encephalitis in our center from June 2020 to April 2021 were enrolled. Data were extracted from the electronic medical record system and analyzed by Student's t test, Mann-Whitney U test, chi-square test, and logistic regression analyses.

Results: This study included a total of 364 patients diagnosed with encephalitis, among which 86 cases (23.6%) had EBV detected in their cerebrospinal fluid (CSF), and 39 cases were diagnosed with EBV-associated encephalitis. The clinical characteristics of EBV-associated encephalitis differ from those caused by other herpes viruses. Compared to other herpes virus-related encephalitis, patients with EBV encephalitis exhibited significantly higher protein levels (1.310 [0.695, 1.840] vs. 0.710 [0.490, 1.700], p < 0.001), lower glucose levels (3.030 [2.585, 3.640] vs. 3.380 [2.990, 4.030], p < 0.001), and a higher incidence of meningeal involvement on MRI (11 (30.6%) vs. 3 (6.5%), p = 0.010). Additionally, univariate logistic regression analysis revealed that age (OR = 1.015, 95% CI: 1.002-1.029), HIV infection (OR = 4.285, 95% CI: 1.582-11.816), non-tumor immunosuppression (OR = 5.713, 95% CI: 1.588-22.883), and peripheral blood EBV infection (OR = 10.204, 95% CI: 4.231-26.346) were independent risk factors for CNS EBV infection.

Conclusion: Compared to other herpes virus-associated encephalitis, EBV encephalitis is characterized by a higher degree of meningeal involvement, elevated CSF protein levels, lower glucose levels, and a reduced T-lymphocyte count in peripheral blood. These characteristics suggest that EBV encephalitis may have a distinct pathophysiology.

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eb病毒相关脑炎的临床特征和危险因素：一项回顾性队列研究

背景：eb病毒（Epstein-Barr virus， EBV）已逐渐被认为是脑炎的重要病原体，但我们对EBV相关脑炎的认识仍然有限。本研究的目的是描述eb病毒相关脑炎的临床特征，并探讨中国患者的危险因素。方法：纳入2020年6月至2021年4月在我中心确诊的所有脑炎患者。数据提取自电子病历系统，采用Student’st检验、Mann-Whitney U检验、卡方检验和logistic回归分析。结果：本研究共纳入364例诊断为脑炎的患者，其中脑脊液检出EBV 86例（23.6%），诊断为EBV相关性脑炎39例。eb病毒相关脑炎的临床特征不同于其他疱疹病毒引起的脑炎。与其他疱疹病毒相关脑炎相比，eb病毒脑炎患者的蛋白水平明显升高（1.310[0.695,1.840]比0.710[0.490,1.700]）。结论：与其他疱疹病毒相关脑炎相比，eb病毒脑炎的特点是脑膜受累度更高，脑脊液蛋白水平升高，血糖水平降低，外周血t淋巴细胞计数减少。这些特征提示EBV脑炎可能具有独特的病理生理学。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Virology Journal 医学-病毒学

CiteScore

7.40

自引率

2.10%

发文量

186

审稿时长

1 months

期刊介绍： Virology Journal is an open access, peer reviewed journal that considers articles on all aspects of virology, including research on the viruses of animals, plants and microbes. The journal welcomes basic research as well as pre-clinical and clinical studies of novel diagnostic tools, vaccines and anti-viral therapies. The Editorial policy of Virology Journal is to publish all research which is assessed by peer reviewers to be a coherent and sound addition to the scientific literature, and puts less emphasis on interest levels or perceived impact.