دورية أكاديمية
أعرض في EDS

Clinical and Metagenomic Characterization of Neurological Infections of People With Human Immunodeficiency Virus in the Peruvian Amazon.

التفاصيل البيبلوغرافية
العنوان: Clinical and Metagenomic Characterization of Neurological Infections of People With Human Immunodeficiency Virus in the Peruvian Amazon.
المؤلفون: Steinberg HE; Department of Microbiology and Immunology, University of Illinois Chicago, Chicago, Illinois, USA., Ramachandran PS; Department of Infectious Diseases, The Peter Doherty Institute for Immunity and Infection, University of Melbourne, Melbourne, Australia.; Department of Neurology, The Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia.; Department of Neurology, St. Vincent's Hospital, University of Melbourne, Melbourne, Australia.; Weill Institute for Neurosciences, Department of Neurology, University of California, SanFrancisco, San Francisco, California, USA., Diestra A; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru., Pinchi L; Asociación Benéfica Prisma, Lima, Peru., Ferradas C; Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.; Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California, USA., Kirwan DE; Institute for Infection and Immunity, St George's, University of London, London, United Kingdom., Diaz MM; Department of Neurology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Sciaudone M; Division of Infectious Diseases, Tulane University School of Medicine, New Orleans, Louisiana, USA., Wapniarski A; Weill Institute for Neurosciences, Department of Neurology, University of California, SanFrancisco, San Francisco, California, USA., Zorn KC; Weill Institute for Neurosciences, Department of Neurology, University of California, SanFrancisco, San Francisco, California, USA., Calderón M; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru., Cabrera L; Asociación Benéfica Prisma, Lima, Peru., Pinedo-Cancino V; Laboratorio de Investigación de Productos Naturales Antiparasitarios de la Amazonía, Centro de Investigación de Recursos Naturales, Universidad Nacional de la Amazonía Peruana, Iquitos, Peru.; Faculty of Human Medicine, Universidad Nacional de la Amazonía Peruana, Iquitos, Peru., Wilson MR; Weill Institute for Neurosciences, Department of Neurology, University of California, SanFrancisco, San Francisco, California, USA., Asayag CR; Department of Clinical Sciences, Universidad Nacional de la Amazonía Peruana, Iquitos, Peru.; Department of Infectious and Tropical Diseases, Hospital Regional de Loreto, Iquitos, Peru., Gilman RH; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA., Bowman NM; Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
مؤلفون مشاركون: Toxoplasmosis Working Group in Peru
المصدر: Open forum infectious diseases [Open Forum Infect Dis] 2023 Oct 27; Vol. 10 (11), pp. ofad515. Date of Electronic Publication: 2023 Oct 27 (Print Publication: 2023).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Published by Oxford University Press on behalf of the Infectious Diseases Society of America Country of Publication: United States NLM ID: 101637045 Publication Model: eCollection Cited Medium: Print ISSN: 2328-8957 (Print) Linking ISSN: 23288957 NLM ISO Abbreviation: Open Forum Infect Dis Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Cary, NC : Published by Oxford University Press on behalf of the Infectious Diseases Society of America, [2014]-
مستخلص: Background: Neurological opportunistic infections cause significant morbidity and mortality in people with human immunodeficiency virus (HIV) but are difficult to diagnose.
Methods: One hundred forty people with HIV with acute neurological symptoms from Iquitos, Peru, were evaluated for cerebral toxoplasmosis with quantitative polymerase chain reaction (qPCR) of cerebrospinal fluid (CSF) and for cryptococcal meningitis with cryptococcal antigen test (CrAg) in serum or CSF. Differences between groups were assessed with standard statistical methods. A subset of samples was evaluated by metagenomic next-generation sequencing (mNGS) of CSF to compare standard diagnostics and identify additional diagnoses.
Results: Twenty-seven participants were diagnosed with cerebral toxoplasmosis by qPCR and 13 with cryptococcal meningitis by CrAg. Compared to participants without cerebral toxoplasmosis, abnormal Glasgow Coma Scale score ( P = .05), unilateral focal motor signs ( P = .01), positive Babinski reflex ( P = .01), and multiple lesions on head computed tomography (CT) ( P = .002) were associated with cerebral toxoplasmosis. Photophobia ( P = .03) and absence of lesions on head CT ( P = .02) were associated with cryptococcal meningitis. mNGS of 42 samples identified 8 cases of cerebral toxoplasmosis, 7 cases of cryptococcal meningitis, 5 possible cases of tuberculous meningitis, and incidental detections of hepatitis B virus (n = 1) and pegivirus (n = 1). mNGS had a positive percentage agreement of 71% and a negative percentage agreement of 91% with qPCR for T gondii . mNGS had a sensitivity of 78% and specificity of 100% for Cryptococcus diagnosis.
Conclusions: An infection was diagnosed by any method in only 34% of participants, demonstrating the challenges of diagnosing neurological opportunistic infections in this population and highlighting the need for broader, more sensitive diagnostic tests for central nervous system infections.
Competing Interests: Potential conflicts of interest. M. R. W. is a co-founder and a member of the board of directors for Delve Bio. All other authors report no potential conflicts.
(© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
References: HIV Res Clin Pract. 2021 Aug;22(4):87-95. (PMID: 34529920)
Genome Res. 2019 May;29(5):831-842. (PMID: 30992304)
N Engl J Med. 2019 Jun 13;380(24):2327-2340. (PMID: 31189036)
Clin Infect Dis. 2010 Aug 15;51(4):448-55. (PMID: 20597693)
PLoS One. 2020 Jul 24;15(7):e0236368. (PMID: 32706836)
Gigascience. 2020 Oct 15;9(10):. (PMID: 33057676)
Clin Infect Dis. 2015 Aug 1;61(3):464-7. (PMID: 25838287)
N Engl J Med. 1992 Dec 3;327(23):1643-8. (PMID: 1359410)
Clin Infect Dis. 2011 Nov;53(10):1019-23. (PMID: 21940419)
Med Mycol Case Rep. 2020 Jun 11;29:29-31. (PMID: 32566468)
BMC Public Health. 2020 May 19;20(1):728. (PMID: 32429863)
J Clin Microbiol. 1995 Sep;33(9):2421-6. (PMID: 7494040)
Nat Commun. 2022 Mar 30;13(1):1675. (PMID: 35354815)
mBio. 2019 Dec 17;10(6):. (PMID: 31848287)
J Clin Microbiol. 1992 Nov;30(11):3000-2. (PMID: 1452673)
Lancet Infect Dis. 2017 Aug;17(8):873-881. (PMID: 28483415)
PLoS Pathog. 2017 Oct 26;13(10):e1006692. (PMID: 29073258)
Pathol Res Pract. 2006;202(11):767-75. (PMID: 16979302)
Autoimmun Rev. 2015 Feb;14(2):160-7. (PMID: 25461469)
JAMA Neurol. 2022 Nov 1;79(11):1095-1096. (PMID: 35994273)
Lancet Neurol. 2012 Jul;11(7):605-17. (PMID: 22710754)
AIDS. 2019 Feb 1;33(2):163-184. (PMID: 29547440)
Emerg Infect Dis. 2014 Jan;20(1):45-53. (PMID: 24378231)
AIDS Res Treat. 2013;2013:709810. (PMID: 23533732)
J Neurol. 1995 Oct;242(10):644-9. (PMID: 8568525)
AIDS. 2009 Feb 20;23(4):525-30. (PMID: 19182676)
معلومات مُعتمدة: MR/P019978/1 United Kingdom MRC_ Medical Research Council; MR/P019978/2 United Kingdom MRC_ Medical Research Council
فهرسة مساهمة: Investigator: C Apaza; M Ayachi; OA Bocanegra; J Bok; LC Pinedo; MD Urquizo; R Gutierrez-Loli; G Pinedo; G Trompeter; S Vazquez; D Zhu
تواريخ الأحداث: Date Created: 20231115 Latest Revision: 20240320
رمز التحديث: 20240320
مُعرف محوري في PubMed: PMC10642733
DOI: 10.1093/ofid/ofad515
PMID: 37965640
قاعدة البيانات: MEDLINE
الوصف
تدمد:2328-8957
DOI:10.1093/ofid/ofad515