Epstein-Barr Virus Central Nervous System Infections and Mortality Risk in Patients Presenting With Suspected Meningitis: Results From the Botswana National Meningitis Survey and the Harare Meningitis Aetiology Study - Summary - MDSpire

Epstein-Barr Virus Central Nervous System Infections and Mortality Risk in Patients Presenting With Suspected Meningitis: Results From the Botswana National Meningitis Survey and the Harare Meningitis Aetiology Study

  • By

  • Jayne Ellis

  • James Milburn

  • Kebatshabile Ngoni

  • Christopher G Williams

  • Charles Muthoga

  • Taddy Mwarumba

  • Ezekiel Gwakuba

  • George Manenji

  • Rachita Suresh

  • Tichoaya Machiya

  • Janet Thubuka

  • Cassie Northcott

  • James Penney

  • Matthew Kinsella

  • Imogen Mechie

  • Samuel Ensor

  • Tshepo Leeme

  • Leah Owen

  • Hannah Barton

  • Keatlaretse Siamisang

  • Mark W Tenforde

  • William Hurt

  • Ronan Doyle

  • Daniel Grint

  • Síle F Molloy

  • Thomas S Harrison

  • David M Goldfarb

  • Madisa Mine

  • Margaret Mokomane

  • Gift Ngwende

  • Lenon Gwaunza

  • Tiny Mazhani

  • Chiratidzo Ndhlovu

  • Joseph N Jarvis

  • October 23, 2025

  • 0 min

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Objective:

To determine the prevalence of Epstein-Barr virus (EBV) CNS infection and its association with in-hospital mortality among patients with suspected meningitis, highlighting its public health significance.

Key Findings:
  • EBV CNS infection was detected in 26% of participants (152 of 581).
  • EBV infection was associated with older age, HIV positivity, and CSF pleocytosis (P < .001).
  • Initial analysis showed an increased in-hospital mortality rate associated with EBV CNS infection (odds ratio 1.64, P = .01), but this association was not significant after adjusting for confounders (adjusted odds ratio 1.29, P = .25).
Interpretation:

EBV CNS infection is common in patients with suspected meningitis, particularly among those with HIV, but does not appear to independently contribute to increased mortality after adjusting for other factors, which has implications for clinical practice.

Limitations:
  • The study's observational nature limits causal inferences.
  • Potential confounding factors, such as specific comorbidities, may not have been fully accounted for in analyses.
Conclusion:

EBV CNS infection likely acts as a bystander virus reflecting heightened CSF inflammation rather than a direct cause of increased mortality in meningitis patients, emphasizing the need for careful clinical assessment.

Original Source(s)

Epstein-Barr Virus Central Nervous System Infections and Mortality Risk in Patients Presenting With Suspected Meningitis: Results From the Botswana National Meningitis Survey and the Harare Meningitis Aetiology Study

  • by Jayne Ellis, James Milburn, Kebatshabile Ngoni, Christopher G Williams, Charles Muthoga, Taddy Mwarumba, Ezekiel Gwakuba, George Manenji, Rachita Suresh, Tichoaya Machiya, Janet Thubuka, Cassie Northcott, James Penney, Matthew Kinsella, Imogen Mechie, Samuel Ensor, Tshepo Leeme, Leah Owen, Hannah Barton, Keatlaretse Siamisang, Mark W Tenforde, William Hurt, Ronan Doyle, Daniel Grint, Síle F Molloy, Thomas S Harrison, David M Goldfarb, Madisa Mine, Margaret Mokomane, Gift Ngwende, Lenon Gwaunza, Tiny Mazhani, Chiratidzo Ndhlovu, Joseph N Jarvis

  • October 23, 2025

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