Development of a multiplex polymerase chain reaction for detection and typing of major human herpesviruses in cerebrospinal fluid

Infections of the central nervous system (CNS) represent a difficult diagnostic problem for both clinicians and microbiologists. In particular, the Herpesviridae family plays a central etiological role in CNS viral infections. These diseases have acquired growing importance in the past few years owing to the increasing number of immunocompromised patients and the availability of new antiviral drugs. Prompt detection and diagnosis of CNS viral infections are critical because most infections are treatable, while a delayed recognition may lead to life-threatening conditions or severe sequelae. The traditional methods for detection of herpesviruses in CNS infections exhibit several drawbacks, whereas the polymerase chain reaction (PCR) on cerebrospinal fluid has revolutionized the neurovirology and is becoming an essential part of the diagnostic work-up of patients with suspected CNS viral infections. A sensitive multiplex PCR method was developed for the simultaneous detection of 6 human herpesviruses (human cytomegalovirus, herpes simplex virus 1, herpes simplex virus 2, Epstein-Barr virus, varicella-zoster virus, and human herpesvirus 6) with the aim of simplifying detection and reducing time and costs. The accuracy, reproducibility, specificity, and sensitivity of these assays were established.