1. Central Nervous System Virus Infection in African Children with Cerebral Malaria.
- Author
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Postels DG, Osei-Tutu L, Seydel KB, Xu Q, Li C, Taylor TE, John CC, Mallewa M, Solomon T, Agbenyega T, Ansong D, Opoka RO, Khan LM, Ramachandran PS, Leon KE, DeRisi JL, Langelier C, and Wilson MR
- Subjects
- Central Nervous System Viral Diseases cerebrospinal fluid, Central Nervous System Viral Diseases complications, Central Nervous System Viral Diseases virology, Child, Coinfection parasitology, Coinfection virology, Female, Ghana, Herpesviridae Infections complications, Herpesviridae Infections parasitology, Herpesviridae Infections virology, High-Throughput Nucleotide Sequencing, Humans, Malaria, Cerebral cerebrospinal fluid, Malaria, Cerebral complications, Malawi, Male, Retinal Diseases parasitology, Retinal Diseases virology, Uganda, Central Nervous System Viral Diseases parasitology, Malaria, Cerebral virology
- Abstract
We aimed to identify the contribution of central nervous system (CNS) viral coinfection to illness in African children with retinopathy-negative or retinopathy-positive cerebral malaria (CM). We collected cerebrospinal fluid (CSF) from 272 children with retinopathy-negative or retinopathy-positive CM and selected CSF from 111 of these children (38 retinopathy positive, 71 retinopathy negative, 2 retinopathy unknown) for analysis by metagenomic next-generation sequencing. We found CSF viral coinfections in 7/38 (18.4%) retinopathy-positive children and in 18/71 (25.4%) retinopathy-negative children. Excluding HIV-1, human herpesviruses (HHV) represented 61% of viruses identified. Excluding HIV-1, CNS viral coinfection was equally likely in children who were retinopathy positive and retinopathy negative ( P = 0.1431). Neither mortality nor neurological morbidity was associated with the presence of virus (odds ratio [OR] = 0.276, 95% CI: 0.056-1.363). Retinopathy-negative children with a higher temperature, lower white blood cell count, or being dehydrated were more likely to have viral coinfection. Level of consciousness at admission was not associated with CNS viral coinfection in retinopathy-negative children. Viral CNS coinfection is unlikely to contribute to coma in children with CM. The herpesviruses other than herpes simplex virus may represent incidental bystanders in CM, reactivating during acute malaria infection.
- Published
- 2020
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