Human herpesviruses in the cornea

Citation
Sb. Kaye et al., Human herpesviruses in the cornea, BR J OPHTH, 84(6), 2000, pp. 563-571
Citations number
58
Categorie Soggetti
Optalmology,"da verificare
Journal title
BRITISH JOURNAL OF OPHTHALMOLOGY
ISSN journal
00071161 → ACNP
Volume
84
Issue
6
Year of publication
2000
Pages
563 - 571
Database
ISI
SICI code
0007-1161(200006)84:6<563:HHITC>2.0.ZU;2-X
Abstract
Aims-To determine the sensitivity and specificity of culture, immunohistoch emistry (IHC), the polymerase chain reaction (PCR), and in situ hybridisati on (ISH) for detecting herpes simplex virus (HSV-I) in the cornea of patien ts undergoing penetrating keratoplasty. To compare the incidence of HSV-1 i n the cornea with that of varicella tester virus (VZV), cytomegalovirus (CM V), and Epstein-Barr virus (EBV). Methods-The corneas of 110 patients, 52 with a documented history of herpes keratitis (HSK) and 58 with non-herpetic corneal disease, were investigate d using IHC, PCR, ISH, and culture. Results-HSV-1 DNA and antigen were detected in 82% and 74% respectively, of corneas of patients with HSK and in 22% and 15% of corneas of patients wit h no history of HSK. The sensitivity of PCR and IHC was 82% and 74% with a specificity of 78% and 85%, respectively. HSV-1 DNA and antigen were found more frequently and in increased amounts in corneas of patients with a shor t interval between their last attack of HSK and surgery. There was a good c orrelation between PCR and IHC in 71%. HSV-1 was isolated by culture in 2%. Latency associated transcripts were not detected using ISH. Evidence of VZ V DNA or antigen was found significantly more frequently in the corneas of patients with a history of HSK (p<0.001). No evidence of EBV or CMV was fou nd in any cornea. Conclusions-PCR and IHC are both sensitive for the detection of HSV-1 in th e cornea. A combination of PCR and IHC increases the specificity for the di agnosis of HSK to 97%. HSV-1. appears to be slowly removed from the cornea. VZV and HSV-1 may co-infect the cornea.