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Predictive value of polymerase chain reaction of cerebrospinal fluid for detection of Epstein-Barr virus to establish the diagnosis of HIV-related primary central nervous system lymphoma.

Polymerase chain reaction (PCR) of cerebrospinal fluid (CSF) for detection of Epstein-Barr virus (EBV) DNA has been proposed as a minimally invasive method for establishing the diagnosis of human immunodeficiency virus-related primary central nervous system lymphoma (PCNSL). In a review of the operational characteristics of this test in our clinical practice, the positive predictive value of CSF PCR for EBV for establishing the diagnosis of PCNSL was only 29%. Of 7 patients with CSF PCR positive for EBV, 2 had PCNSL, and 5 received alternative diagnoses (specificity, 79.1%).