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Herpes simplex keratitis in South India: clinico-virological correlation.
Jpn J Ophthalmol 1999 Jul-Aug; 43(4):303-7JJ

Abstract

PURPOSE

A retrospective cross-section study to analyze the prevalence of herpes simplex virus-induced keratitis (HSK) among 3,000 patients attending a corneal clinic in South India between 1995 and 1997, and to evaluate laboratory techniques for detecting HSK.

METHODS

The clinico-virological correlation was studied using herpes simplex virus (HSV) isolation on the Vero cell line, HSV-specific antigen detection by indirect immunofluorescence (IF) microscopy, and serum anti-HSV IgG quantitation, IgM estimation, and tear secretory IgA (sIgA) detection by ELISA.

OBSERVATIONS

HSK had a prevalence of 7.8% (234 patients) in this study. A virological correlation could be obtained in 44.4% of the cases that had epithelial manifestations and in 14.8% of the cases that had only stromal disease. In 161 cases where both culture and IF microscopy were used, IF detected 27 cases (26.8%) more than cell culture. The difference in sensitivity between cell culture and IF was found to be statistically significant (McNemar's test, P < .05). An elevation in IgG titer was seen in 17 (30.4%) cases. IgM was detected in only 2 cases of the 62 (3.2%) analyzed. Of the 138 cases analyzed, sIgA was positive in 28 (20.3%) cases. A proved diagnosis could be made in 58% of cases when the specimen was collected during the first week after disease onset, and in only 5% when the time interval increased to 4 weeks.

CONCLUSIONS

HSV antigen detection by indirect IF is a rapid and sensitive diagnostic tool for HSK. Tear secretory IgA (sIgA) is a specific marker for acute herpetic keratitis, and the detection of HSV-specific tear sIgA is a valuable adjunct to virus isolation and antigen detection in the laboratory diagnosis of HSK. For a successful diagnosis, the specimen should be collected as soon as possible after HSK onset.

Authors+Show Affiliations

Department of Microbiology, Dr. ALM Post Graduate Institute of Basic Medical Sciences, University of Madras, Taramani, Chennai, India.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10482477

Citation

Pramod, N P., et al. "Herpes Simplex Keratitis in South India: Clinico-virological Correlation." Japanese Journal of Ophthalmology, vol. 43, no. 4, 1999, pp. 303-7.
Pramod NP, Rajendran P, Kannan KA, et al. Herpes simplex keratitis in South India: clinico-virological correlation. Jpn J Ophthalmol. 1999;43(4):303-7.
Pramod, N. P., Rajendran, P., Kannan, K. A., & Thyagarajan, S. P. (1999). Herpes simplex keratitis in South India: clinico-virological correlation. Japanese Journal of Ophthalmology, 43(4), pp. 303-7.
Pramod NP, et al. Herpes Simplex Keratitis in South India: Clinico-virological Correlation. Jpn J Ophthalmol. 1999;43(4):303-7. PubMed PMID: 10482477.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Herpes simplex keratitis in South India: clinico-virological correlation. AU - Pramod,N P, AU - Rajendran,P, AU - Kannan,K A, AU - Thyagarajan,S P, PY - 1999/9/11/pubmed PY - 1999/9/11/medline PY - 1999/9/11/entrez SP - 303 EP - 7 JF - Japanese journal of ophthalmology JO - Jpn. J. Ophthalmol. VL - 43 IS - 4 N2 - PURPOSE: A retrospective cross-section study to analyze the prevalence of herpes simplex virus-induced keratitis (HSK) among 3,000 patients attending a corneal clinic in South India between 1995 and 1997, and to evaluate laboratory techniques for detecting HSK. METHODS: The clinico-virological correlation was studied using herpes simplex virus (HSV) isolation on the Vero cell line, HSV-specific antigen detection by indirect immunofluorescence (IF) microscopy, and serum anti-HSV IgG quantitation, IgM estimation, and tear secretory IgA (sIgA) detection by ELISA. OBSERVATIONS: HSK had a prevalence of 7.8% (234 patients) in this study. A virological correlation could be obtained in 44.4% of the cases that had epithelial manifestations and in 14.8% of the cases that had only stromal disease. In 161 cases where both culture and IF microscopy were used, IF detected 27 cases (26.8%) more than cell culture. The difference in sensitivity between cell culture and IF was found to be statistically significant (McNemar's test, P < .05). An elevation in IgG titer was seen in 17 (30.4%) cases. IgM was detected in only 2 cases of the 62 (3.2%) analyzed. Of the 138 cases analyzed, sIgA was positive in 28 (20.3%) cases. A proved diagnosis could be made in 58% of cases when the specimen was collected during the first week after disease onset, and in only 5% when the time interval increased to 4 weeks. CONCLUSIONS: HSV antigen detection by indirect IF is a rapid and sensitive diagnostic tool for HSK. Tear secretory IgA (sIgA) is a specific marker for acute herpetic keratitis, and the detection of HSV-specific tear sIgA is a valuable adjunct to virus isolation and antigen detection in the laboratory diagnosis of HSK. For a successful diagnosis, the specimen should be collected as soon as possible after HSK onset. SN - 0021-5155 UR - https://www.unboundmedicine.com/medline/citation/10482477/Herpes_simplex_keratitis_in_South_India:_clinico_virological_correlation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-5155(99)00026-X DB - PRIME DP - Unbound Medicine ER -