BKPyV causing meningoencephalitis in HIV/AIDS patients in Argentina

Abstract

Opportunistic infections in the central nervous system (CNS) by JCPyV/BKPyV in HIV/AIDS patients increase morbidity/mortality, especially in low-income countries. In Argentina, data regarding CNS-infection by polyomavirus in HIV/AIDS are scarce. We retrospectively evaluated BKPyV/JCPyV infections in cerebrospinal fluid (CSF) samples of HIV/AIDS patients with meningoencephalitis or Progressive Multifocal Leukoencephalopathy (PML) from Salta, Argentina, a province with high rates of mortality from AIDS. Cryopreserved CSF samples from all HIV/AIDS patients with BKPyV/JCPyV admitted to a regional referral hospital for one year underwent amplification of 173 pb T-antigen sequence by PCR, searching for polyomavirus DNA. Subsequently, polyomavirus genotyping by direct sequencing was performed. Six percent (3/50) of the patients with CNS disorders had polyomavirus; one patient with meningoencephalitis had BKPyV, and 2 patients with PML had JCPyV. One genotype 2A was identified. To our knowledge, this is the first description of BKPyV-associated meningoencephalitis in HIV/AIDS patients in Argentina, together with the first report of JCPyV genotype 2 responsible for neurological disease in a patient with HIV/AIDS in the country. These data support the systematic incorporation of molecular diagnosis for BKPyV /JCPyV into routine screening of CSF in patients with HIV/AIDS and neurological diseases in Argentina. Etiological diagnosis of CNS diseases in these patients is overriding.