Login Register Cart 0
Generic placeholder image

Current HIV Research

Editor-in-Chief

ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Case Report

Epstein-Barr Encephalitis in a Child with Congenital Human Immunodeficiency Virus Infection: A Case Report Calling for No Forgetfulness

Author(s): Olga Tsiatsiou, Savvas Papachristou, Eleni Papadimitriou, Elisavet Michailidou, Dimitrios Chatzidimitriou, Anna Papa, Vai Doulioglou, Stavroula Karyda, Charalampos Antachopoulos and Emmanuel Roilides*

Volume 18, Issue 1, 2020

Page: [63 - 66] Pages: 4

DOI: 10.2174/1570162X17666191017101223

Price: $65

Abstract

Background: In resource-rich settings, the rate of mother-to-child transmission of human immunodeficiency virus (HIV) has dramatically decreased by virtue of a combination of preventive strategies during the last two decades.

Case Presentation: We present a case of progressive developmental milestone loss in a toddler with previously unknown congenitally acquired human immunodeficiency virus (HIV) infection, complicated by an Epstein-Barr virus (EBV) coinfection.

Conclusion: Our report underscores the differential diagnosis between HIV encephalopathy and EBV encephalitis and the vertical transmission of the HIV infection, which constitutes an alarming issue in terms of public health.

Keywords: Human immunodeficiency virus, Epstein-Barr virus, vertical transmission, encephalopathy, encephalitis, developmental regression.

« Previous
Graphical Abstract

[1]
Townsend CL, Byrne L, Cortina-Borja M, et al. Earlier initiation of ART and further decline in mother-to-child HIV transmission rates, 2000-2011. AIDS 2014; 28(7): 1049-57.
[http://dx.doi.org/10.1097/QAD.0000000000000212] [PMID: 24566097]
[2]
Donald KA, Walker KG, Kilborn T, et al. HIV Encephalopathy: pediatric case series description and insights from the clinic coalface. AIDS Res Ther 2015; 12(1): 2.
[http://dx.doi.org/10.1186/s12981-014-0042-7] [PMID: 25598835]
[3]
Cinque P, Vago L, Dahl H, et al. Polymerase chain reaction on cerebrospinal fluid for diagnosis of virus-associated opportunistic diseases of the central nervous system in HIV-infected patients. AIDS 1996; 10(9): 951-8.
[http://dx.doi.org/10.1097/00002030-199610090-00004] [PMID: 8853727]
[4]
Hashemian S, Ashrafzadeh F, Akhondian J, Beiraghi Toosi M. Epstein-barr virus encephalitis: a case report. Iran J Child Neurol 2015; 9(1): 107-10.
[PMID: 25767548]
[5]
Weinberg A, Li S, Palmer M, Tyler KL. Quantitative CSF PCR in Epstein-Barr virus infections of the central nervous system. Ann Neurol 2002; 52(5): 543-8.
[http://dx.doi.org/10.1002/ana.10321] [PMID: 12402250]
[6]
Slyker JA, Casper C, Tapia K, et al. Clinical and virologic manifestations of primary Epstein-Barr virus (EBV) infection in Kenyan infants born to HIV-infected women. J Infect Dis 2013; 207(12): 1798-806.
[http://dx.doi.org/10.1093/infdis/jit093] [PMID: 23493724]
[7]
Petrara MR, Penazzato M, Massavon W, et al. Epstein-Barr virus load in children infected with human immunodeficiency virus type 1 in Uganda. J Infect Dis 2014; 210(3): 392-9.
[http://dx.doi.org/10.1093/infdis/jiu099] [PMID: 24550442]
[8]
Siddiqi OK, Ghebremichael M, Dang X, et al. Molecular diagnosis of central nervous system opportunistic infections in HIV-infected Zambian adults. Clin Infect Dis 2014; 58(12): 1771-7.
[http://dx.doi.org/10.1093/cid/ciu191] [PMID: 24668125]
[9]
Martelius T, Lappalainen M, Palomäki M, Anttila V-J. Clinical characteristics of patients with Epstein Barr virus in cerebrospinal fluid. BMC Infect Dis 2011; 11: 281.
[http://dx.doi.org/10.1186/1471-2334-11-281] [PMID: 22018204]
[10]
Chaudhuri A, Kennedy PG. Diagnosis and treatment of viral encephalitis. Postgrad Med J 2002; 78(924): 575-83.
[http://dx.doi.org/10.1136/pmj.78.924.575] [PMID: 12415078]
[11]
Davis LE. Diagnosis and treatment of acute encephalitis. Neurologist 2000; 6: 145-59.
[http://dx.doi.org/10.1097/00127893-200006030-00001]
[12]
Safriel YI, Haller JO, Lefton DR, Obedian R. Imaging of the brain in the HIV-positive child. Pediatr Radiol 2000; 30(11): 725-32.
[http://dx.doi.org/10.1007/s002470000338] [PMID: 11100486]
[13]
Laughton B, Cornell M, Grove D, et al. Early antiretroviral therapy improves neurodevelopmental outcomes in infants. AIDS 2012; 26(13): 1685-90.
[http://dx.doi.org/10.1097/QAD.0b013e328355d0ce] [PMID: 22614886]
[14]
Trevillyan JM, Mahony AA, McLean C, Hoy JF. Successful treatment of Epstein-Barr virus encephalitis in the setting of HIV-associated neurocognitive disorder: a diagnostic and therapeutic challenge. Antivir Ther (Lond) 2013; 18(2): 257-61.
[http://dx.doi.org/10.3851/IMP2451] [PMID: 23475078]
[15]
Tyler KL, McArthur JC. Through a glass, darkly: cerebrospinal fluid viral load measurements and the pathogenesis of human immunodeficiency virus infection of the central nervous system. Arch Neurol 2002; 59(6): 909-12.
[http://dx.doi.org/10.1001/archneur.59.6.909] [PMID: 12056925]
[16]
Antinori A, Cingolani A, Giancola ML, Forbici F, De Luca A, Perno CF. Clinical implications of HIV-1 drug resistance in the neurological compartment. Scand J Infect Dis Suppl 2003; 106: 41-4.
[http://dx.doi.org/10.1080/03008870310009650] [PMID: 15000582]
[17]
MacGinley R, Bartley PB, Sloots T, Johnson DW. Epstein-Barr virus encephalitis in a renal allograft recipient diagnosed by polymerase chain reaction on cerebrospinal fluid and successfully treated with ganciclovir. Nephrol Dial Transplant 2001; 16(1): 197-8.
[http://dx.doi.org/10.1093/ndt/16.1.197] [PMID: 11209035]
[18]
Katramados AM, Sripathi N, Brar I, Mitsias PD. Intravenous ganciclovir consistently induces remission of persistent Epstein-Barr encephalitis in an HIV-1-infected patient. AIDS 2007; 21(6): 778-80.
[http://dx.doi.org/10.1097/QAD.0b013e3280b07784] [PMID: 17413706]
[19]
Bossolasco S, Falk KI, Ponzoni M, et al. Ganciclovir is associated with low or undetectable Epstein-Barr virus DNA load in cerebrospinal fluid of patients with HIV-related primary central nervous system lymphoma. Clin Infect Dis 2006; 42(4): e21-5.
[http://dx.doi.org/10.1086/499956] [PMID: 16421782]
[20]
Lehman DA, Farquhar C. Biological mechanisms of vertical human immunodeficiency virus (HIV-1) transmission. Rev Med Virol 2007; 17(6): 381-403.
[http://dx.doi.org/10.1002/rmv.543] [PMID: 17542053]
[21]
John GC, Nduati RW, Mbori-Ngacha DA, et al. Correlates of mother-to-child human immunodeficiency virus type 1 (HIV-1) transmission: association with maternal plasma HIV-1 RNA load, genital HIV-1 DNA shedding, and breast infections. J Infect Dis 2001; 183(2): 206-12.
[http://dx.doi.org/10.1086/317918] [PMID: 11120927]
[22]
Panel on Treatment of Pregnant Women with HIV Infection and Prevention of Perinatal Transmission. AIDSinfo 2016 [cited 2018 Oct 25]; Available from: http://aidsinfo.nih.gov/contentfiles/lvguidelines/%0APerinatalGL.pdf
[23]
Favarato G, Bailey H, Burns F, Prieto L, Soriano-Arandes A, Thorne C. Migrant women living with HIV in Europe: are they facing inequalities in the prevention of mother-to-child-transmission of HIV?: The European Pregnancy and Paediatric HIV Cohort Collaboration (EPPICC) study group in EuroCoord. Eur J Public Health 2018; 28(1): 55-60.
[http://dx.doi.org/10.1093/eurpub/ckx048] [PMID: 28449111]
[24]
Kost BP, Gingelmaier A, Kainer F, Friese K, Mylonas I. HIV testing in pregnancy: are we testing enough? Arch Gynecol Obstet 2011; 284(2): 357-60.
[http://dx.doi.org/10.1007/s00404-010-1639-2] [PMID: 20717687]

Rights & Permissions Print Cite
Article Metrics
28
2
World Immunization Week
© 2024 Bentham Science Publishers | Privacy Policy