Viral Agents In The Cerebrospinal Fluid Of Hospitalized Hiv Patients With Meningitis At The Fevers Unit, Korle- Bu Teaching Hospital

ABSTRACT Introduction: Meningitis is one of the leading causes of death among patients living with HIV in sub-Saharan Africa. Based on clinical presentations, the different types of meningitis may not be distinguished from each other therefore, accurate laboratory diagnosis is extremely essential. Viruses such as Enteroviruses, Mumps virus and Herpes Simplex Virus-1 are implicated in cases of meningitis. Aim: The aim of the study was to determine the prevalence of viral meningitis among hospitalized HIV patients at the Fevers Unit (FU) of Korle Bu Teaching Hospital (KBTH). Method: This was a cross-sectional study in which cerebrospinal fluid (CSF) specimens were collected from hospitalized HIV patients at the FU of KBTH with clinical features of meningitis but yet to be confirmed. Specimens were tested by Real-time PCR for Enteroviruses, Mumps Virus and Herpes Simplex Virus-1. Clinical and laboratory tests data on patients were analyzed and CSF parameters were also ascertained. Results: A total of 80 CSF specimens were collected from patients. Thirty- seven (37) of the subjects were males and 43 were females. Majority (81.25%) of the patients were between the ages of 30 and 49 years. The major clinical symptoms seen in the patients were headache and fever with 35% exhibiting meningismus. Lymphocytic pleocytosis was observed in 30 while neutrophilic predominance was observed in 7 of the subjects. About two-thirds (53) of the patients had CD4 count less than 200cells/mm3 and most were in Stage III and IV of HIV (68). Patients within normal range of glucose accounted for 71.25% while patients with elevated glucose level were 5 (6.25%). Fifty-four (67.50%) of the subjects had an elevated CSF protein level while 26(32.50%) had a CSF protein level less than 0.45. Most (68.75%) of the patients were not on ART.  The study was unable to detect Enteroviruses, Mumps virus and HSV-1 in the CSF of patients with suspected meningitis by real time PCR. Conclusion: None of the viruses (EV, MuV, HSV-1) investigated in this study was implicated in the suspected cases of meningitis. However, lymphocytic pleocytosis, normal glucose and elevated protein levels were observed in majority of study participants