Epstein-Barr virus and cryptococcus are more predominant pathogens in cerebrospinal fluid of people living with HIV with low CD4 + cell counts

Background: To investigate the pathogen spectrum in central nervous system (CNS) of patients with HIV can provide early diagnosis and timely treatment. Methods: : Epstein-Barr virus (EBV), cytomegalovirus (CMV) and tuberculous bacillus (TB) DNA were measured by real time (RT)-PCR. Enzyme linked immunosorbent assays were used to test the antibodies to CMV and EBV, and the antigen to cryptococcus. The CSF was cultured for microorganisms. Results: : The most common virus was EBV (29.3% positive detection rate) in cerebrospinal fluid (CSF), followed by CMV (6% positive detection rate). Interestingly, the positive rate of CMV-IgG antibody was 58.5% in CSF and 95.2% in plasma while the positive rate of CMV-IgM antibody was 2.4% in CSF and 14.3% in plasma. The positive rate of cryptococcal antigen was 27% in CSF and 43.6% in plasma. The total positive rate of pathogenic microbe culture in CSF was 21%, and the higher positive rate was related with the lower CD4 + cell count. Almost 96% positive cultured microbe in CSF were cryptococcus. Conclusions: : These results suggest that EBV and cryptococcus were the most common pathogens in CNS of patients living with HIV, more attention need to be paid to the role of EBV and cryptococcus in AIDS progression.