BACKGROUND: Acute enterovirus (EV) meningitis is a major cause of hospitalization among adults and children. It is caused by multiple EV genotypes assigned to 4 species (EV-A, EV-B, EV-C, and EV-D). METHODS: We determined viral loads in the cerebrospinal fluid (CSF) of 156 patients of all ages with EV meningitis during a 5-year observational prospective study. The virus strains were genotyped, and their time origin was determined with Bayesian phylogenetic methods. RESULTS: The CSF viral loads ranged between 3.4 and 7.5 log10 copies/mL (median, 4.9 log10 copies/mL). They were higher in neonates than in infants and children (P = .02) but were comparable in adults. Viral loads were associated with EV genotypes (P < .001). The EV strains were identified in 152 of 156 patients and assigned to 23 genotypes within the EV-A and EV-B species. The most frequent genotypes, echoviruses 6 and 30, were associated with different viral loads (P < .001). The highest viral loads were in meningitis cases caused by coxsackievirus A9, B4, and B5 genotypes. Most patients infected by a same genotype were infected by a major virus variant of recent emergence. CONCLUSIONS: The variations in CSF viral loads in patients at the onset of EV meningitis are related to genotypic differences in the virus strains involved.
BACKGROUND: Acute enterovirus (EV) meningitis is a major cause of hospitalization among adults and children. It is caused by multiple EV genotypes assigned to 4 species (EV-A, EV-B, EV-C, and EV-D). METHODS: We determined viral loads in the cerebrospinal fluid (CSF) of 156 patients of all ages with EV meningitis during a 5-year observational prospective study. The virus strains were genotyped, and their time origin was determined with Bayesian phylogenetic methods. RESULTS: The CSF viral loads ranged between 3.4 and 7.5 log10 copies/mL (median, 4.9 log10 copies/mL). They were higher in neonates than in infants and children (P = .02) but were comparable in adults. Viral loads were associated with EV genotypes (P < .001). The EV strains were identified in 152 of 156 patients and assigned to 23 genotypes within the EV-A and EV-B species. The most frequent genotypes, echoviruses 6 and 30, were associated with different viral loads (P < .001). The highest viral loads were in meningitis cases caused by coxsackievirus A9, B4, and B5 genotypes. Most patients infected by a same genotype were infected by a major virus variant of recent emergence. CONCLUSIONS: The variations in CSF viral loads in patients at the onset of EV meningitis are related to genotypic differences in the virus strains involved.
Authors: Nguyen Thi Thuy Chinh B'Krong; Ngo Ngoc Quang Minh; Phan Tu Qui; Tran Thi Hong Chau; Ho Dang Trung Nghia; Lien Anh Ha Do; Nguyen Ngoc Nhung; Nguyen Van Vinh Chau; Guy Thwaites; Le Van Tan; H Rogier van Doorn; Tran Tan Thanh Journal: Virol J Date: 2018-04-12 Impact factor: 4.099
Authors: Silke Vollbach; Andreas Müller; Jan Felix Drexler; Arne Simon; Christian Drosten; Anna Maria Eis-Hübinger; Marcus Panning Journal: Virol J Date: 2015-11-25 Impact factor: 4.099
Authors: Hans de Graaf; Emanuela Pelosi; Andrea Cooper; John Pappachan; Kim Sykes; Iain MacIntosh; Diane Gbesemete; Tristan W Clark; Sanjay V Patel; Saul N Faust; Marc Tebruegge Journal: Pediatr Infect Dis J Date: 2016-07 Impact factor: 2.129