Molecular Detection and Characterization of Neurotropic DNA Viruses in Important Neurological Diseases seen in a Tertiary Hospital in India South

Abstract

Infections of the CNS are a major cause of morbidity and mortality among hospitalised patients with CNS disorders. These present as acute or chronic conditions and viral etiologies are a major cause of such disease. India has multiple recorded epidemics of Japanese encephalitis virus a006Ed enteroviral infections that tend to occur as epidemics. However, CNS diseases like meningitis, aseptic meningitis, meningoencephalitis, ADEM, GBS and motor neuron disease cases are also seen throughout the year. Neurologists in India routinely diagnose encephalitis due to HSV, based on clinical, CSF findings and imaging and are able to in many instances successfully treat with antivirals. The role of other viruses is not routinely newlineinvestigated. In most hospitals in India, other than some national institutes or corporate hospitals, it is difficult to establish documentary evidence of viral infections. Molecular testing for viral genomic material is restricted to a small percentage of specialised hospitals. In our opinion, this is the first comprehensive attempt at looking for multiple DNA viruses in CNS infections. In the early phase of this study, a non-nested multiplex conventional PCR was used and subsequently a multiplex real-time PCR was applied. A non-nested multiplex conventional PCR has been established and tested on 158 CSF samples, 126 from patients and 21 from controls. In 11 samples, the housekeeping tubulin gene was not amplified on testing twice. These 11 samples were excluded from analysis. Hence, the multiplex PCR data was analysed on 126 patients with suspected neurological disease of viral etiology and 21 controls with other CNS abnormalities. One of the major problems which hinder longitudinal studies newlineis the loss of patients to long term follow-up. We are also unable to comment on the substantial detection of HHV-6 in our study groups because of the discrepancy between our findings by real-time PCR using two different sets of primers i.e. target 1 and 2. newline newline