[Meningitis associated with reactivation of varicella-zoster virus]. / Meningitt ved reaktivering av varicella zoster-virus.

BACKGROUND: Reactivation of varicella-zostervirus (VZV) can manifest as infection of the central nervous system. The detection of VZV DNA in cerebrospinal fluid by polymerase chain reaction has extended our knowledge about the frequency of various clinical manifestations in the immunocompetent host, also without the typical rash of shingles. MATERIAL AND METHODS: Over a period of three years, 1999 through 2001, we performed VZV polymerase chain reaction in cerebrospinal fluid in 364 patients with suspected infection of the central nervous system. RESULTS: We detected VZV DNA in the cerebrospinal fluid in five patients. Four of the patients had reactivated VZV infection. Meningitis was seen in two young immunocompetent individuals; one of them without shingles. One patient had myelitis without shingles and one had zoster radiculitis. One patient was a child with encephalitis and primary infection. INTERPRETATION: Our results are similar to results from other investigators that have found VZV DNA in the cerebrospinal fluid in immunocompetent patients with meningitis or encephalitis as the most common clinical manifestation, with or without shingles.

Rev inhibition strongly affects intracellular distribution of human immunodeficiency virus type 1 RNAs.

To define the human immunodeficiency virus type 1 (HIV-1) RNA maturation pathways, we analyzed the intracellular distribution of HIV-1 RNA and the viral regulatory proteins Rev and Tat in transfected COS cells and HIV-1-infected lymphoid C8166 cells by means of ultrastructural in situ hybridization using antisense RNA probes and immunoelectron microscopy. The intranuclear viral RNA occurs in ribonucleoprotein fibrils in the perichromatin and interchromatin regions. The simultaneous demonstration of Rev, Tat, Br-labeled RNA, and cellular proteins SC35 and CRM1 in such fibrils reveals the potential of Rev to associate with nascent HIV pre-mRNA and its splicing complex and transport machinery. In a rev-minus system, the env intron-containing, incompletely spliced viral RNAs are revealed only in the nucleus, indicating that Rev is required to initiate the transport to the cytoplasm. Moreover, env intron sequences frequently occur in the periphery of interchromatin granule clusters, while the probe containing the rev exon sequence does not associate with this nucleoplasmic domain. When cells were treated with the CRM1 inhibitor leptomycin B in the presence of Rev protein, the env intron containing HIV RNAs formed clusters throughout the nucleoplasm and accumulated at the nuclear pores. This suggests that Rev is necessary and probably also sufficient for the accumulation of incompletely spliced HIV RNAs at the nuclear pores while CRM1 is needed for translocation across the nuclear pore complex.