Presence of Herpesviridae Genome in CSF of GBS Patients

H. Rahaman, H. Z. Rahman, M. Rana, Md. Rafiqul Islam, M. Hannan, Md Jafrul Kawsar, Chowdhury Neamul Hasan Refayet, M. Hasan, Imran Sarker, Maftahul Jannat, -. Md Wahiduzzaman
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Abstract

Background: Guillain Barre Syndrome (GBS) is considered as an immune mediated inflammatory disease of peripheral nerves and nerve roots. Herpes viruses like CMV, EBV, HSV and VZV infections are associated with GBS. The aim of the study was to identify the presence and frequency of different Herpes virus genome by PCR assay in CSF of GBS patients Methods: An observational, cross sectional study was carried out in the Department of Neurology, BSMMU, and Dhaka. A total 50 (fifty) admitted GBS patients were included after fulfilling the inclusion and exclusion criteria. About 2 ml of CSF was taken for detection of viral nucleic of CMV, EBV, HSV1, HSV2, VZV and HHV6 by Multiplex PCR method. Results: Herpesviridae genome in CSF of study population was present in 9 (18%) patients. Maximum 3 (33.3%) cases were HSV1, EBV and HSV2 found in 2 (22.2%) patients, CMV and VZV in 1 (11.1%) patient respectively. AMAN (66.6%) was the most frequent electrophysiological pattern; followed by AIDP (33.3%), mean CSF protein was (159±81) mg/dl and mean cell count was (2±3)/cmm in these patients. Herpes virus genome positive group patients were more disabled and received definitive treatment more than the others. Conclusion: Herpesviridae genome was present in CSF of GBS especially in early collected CSF sample. Antiviral drugs might have a role in treating GBS patients having Herpes virus genome in CSF. Bangladesh Journal of Neuroscience 2018; Vol. 34 (1): 39-44
GBS患者脑脊液中疱疹病毒基因组的存在
背景:格林-巴利综合征(GBS)被认为是一种免疫介导的周围神经和神经根炎症性疾病。疱疹病毒如巨细胞病毒、EBV、HSV和VZV感染与GBS有关。本研究的目的是通过PCR检测确定GBS患者脑脊液中不同疱疹病毒基因组的存在和频率。方法:在BSMMU神经内科和达卡进行了一项观察性横断面研究。在满足纳入和排除标准后,共纳入50例入院的GBS患者。取CSF约2ml,采用多重PCR法检测CMV、EBV、HSV1、HSV2、VZV和HHV6病毒核酸。结果:9例(18%)患者脑脊液中存在疱疹病毒基因组。HSV1、EBV、HSV2分别出现2例(22.2%)、CMV、VZV分别出现1例(11.1%),最多3例(33.3%)。AMAN(66.6%)是最常见的电生理模式;其次是AIDP(33.3%),平均脑脊液蛋白为(159±81)mg/dl,平均细胞计数为(2±3)个/cmm。疱疹病毒基因组阳性组患者比其他组残疾和接受明确治疗的患者更多。结论:GBS患者脑脊液中存在疱疹病毒基因组,尤其是早期采集的脑脊液中。抗病毒药物可能对脑脊液中有疱疹病毒基因组的GBS患者有治疗作用。孟加拉国神经科学杂志2018;Vol. 34 (1): 39-44
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