PDF(Pubmed)
Abstract：
OBJECTIVE: Human Borna disease virus (BoDV-1) encephalitis is an emerging disease in Germany. This study investigates the spectrum of human BoDV-1 infection, characterizes anti-BoDV-1-antibodies and kinetics, and compares laboratory test performances.
METHODS: Three hundred four encephalitis cases, 308 nation-wide neuropsychiatric conditions, 127 well-defined psychiatric cases from Borna disease-endemic areas, and 20 persons with contact to BoDV-1 encephalitis patients or animals were tested for BoDV-1 infections by serology and PCR.
RESULTS: BoDV-1 infections were only found in encephalitis patients with residence in, or recent travel to, virus-endemic areas. Antibodies were detected as early as 12 days after symptom onset. Serum antibody levels correlated with disease duration. Serology was ordered after 50% of the disease duration had elapsed, reflecting low awareness. BoDV-1-antibodies were of IgG1 subclass, and the epitope on BoDV-1 antigens was determined. Specificity of the indirect immunofluorescence antibody test (IFAT) and lineblot (LB) from serum and cerebrospinal fluid (CSF), as well as PCR testing from CSF, was 100%. Sensitivity, depending on first or all samples, reached 75-86% in serum and 92-94% in CSF for the IFAT, and 33-57% in serum and 18-24% in CSF for the LB. Sensitivity for PCR in CSF was 25-67%. Positive predictive values were 100% each, while negative predictive values were 99% (IFAT), 91-97% (LB), and 90% (PCR).
CONCLUSIONS: There is no hint that BoDV-1 causes other diseases than encephalitis in humans. Awareness has to be increased in virus-endemic areas. Tests are robust but lack sensitivity. Detection of IgG1 against specific peptides may facilitate diagnosis. Screening of healthy individuals is likely not beneficial.
METHODS: Three hundred four encephalitis cases, 308 nation-wide neuropsychiatric conditions, 127 well-defined psychiatric cases from Borna disease-endemic areas, and 20 persons with contact to BoDV-1 encephalitis patients or animals were tested for BoDV-1 infections by serology and PCR.
RESULTS: BoDV-1 infections were only found in encephalitis patients with residence in, or recent travel to, virus-endemic areas. Antibodies were detected as early as 12 days after symptom onset. Serum antibody levels correlated with disease duration. Serology was ordered after 50% of the disease duration had elapsed, reflecting low awareness. BoDV-1-antibodies were of IgG1 subclass, and the epitope on BoDV-1 antigens was determined. Specificity of the indirect immunofluorescence antibody test (IFAT) and lineblot (LB) from serum and cerebrospinal fluid (CSF), as well as PCR testing from CSF, was 100%. Sensitivity, depending on first or all samples, reached 75-86% in serum and 92-94% in CSF for the IFAT, and 33-57% in serum and 18-24% in CSF for the LB. Sensitivity for PCR in CSF was 25-67%. Positive predictive values were 100% each, while negative predictive values were 99% (IFAT), 91-97% (LB), and 90% (PCR).
CONCLUSIONS: There is no hint that BoDV-1 causes other diseases than encephalitis in humans. Awareness has to be increased in virus-endemic areas. Tests are robust but lack sensitivity. Detection of IgG1 against specific peptides may facilitate diagnosis. Screening of healthy individuals is likely not beneficial.
摘要：
目的：人类博尔纳病病毒（BoDV-1）脑炎是德国的新兴疾病。这项研究调查了人类BoDV-1感染的频谱，表征抗BoDV-1抗体和动力学，并比较了实验室测试性能。
方法：34例脑炎，308全国范围内的神经精神疾病，来自博尔纳病流行地区的127例明确定义的精神病病例，通过血清学和PCR检测了20名与BoDV-1脑炎患者或动物接触的人的BoDV-1感染。
结果：仅在居住于或者最近的旅行，病毒流行区。早在症状发作后12天就检测到抗体。血清抗体水平与疾病持续时间相关。在50％的疾病持续时间过去后订购血清学，反映低意识。BoDV-1抗体属于IgG1亚类，并确定BoDV-1抗原上的表位。来自血清和脑脊液（CSF）的间接免疫荧光抗体测试（IFAT）和线性印迹（LB）的特异性，以及CSF的PCR检测，是100%。灵敏度,根据第一个或所有样本，IFAT的血清达到75-86%，CSF达到92-94%，对于LB，血清中为33-57％，CSF中为18-24％。CSF中PCR的灵敏度为25-67%。阳性预测值分别为100%，而阴性预测值为99%(IFAT)，91-97%（LB），90％（PCR）。
结论：没有迹象表明BoDV-1会导致人类脑炎以外的其他疾病。必须提高病毒流行地区的认识。测试是稳健的，但缺乏敏感性。针对特定肽的IgG1的检测可以促进诊断。筛查健康个体可能是无益的。
方法：34例脑炎，308全国范围内的神经精神疾病，来自博尔纳病流行地区的127例明确定义的精神病病例，通过血清学和PCR检测了20名与BoDV-1脑炎患者或动物接触的人的BoDV-1感染。
结果：仅在居住于或者最近的旅行，病毒流行区。早在症状发作后12天就检测到抗体。血清抗体水平与疾病持续时间相关。在50％的疾病持续时间过去后订购血清学，反映低意识。BoDV-1抗体属于IgG1亚类，并确定BoDV-1抗原上的表位。来自血清和脑脊液（CSF）的间接免疫荧光抗体测试（IFAT）和线性印迹（LB）的特异性，以及CSF的PCR检测，是100%。灵敏度,根据第一个或所有样本，IFAT的血清达到75-86%，CSF达到92-94%，对于LB，血清中为33-57％，CSF中为18-24％。CSF中PCR的灵敏度为25-67%。阳性预测值分别为100%，而阴性预测值为99%(IFAT)，91-97%（LB），90％（PCR）。
结论：没有迹象表明BoDV-1会导致人类脑炎以外的其他疾病。必须提高病毒流行地区的认识。测试是稳健的，但缺乏敏感性。针对特定肽的IgG1的检测可以促进诊断。筛查健康个体可能是无益的。
