Subhan Shaheen, Jose Roby James, Duggirala Aparna, Hari R, Krishna Pravin, Reddy Sesha, Sharma Savitri
Jhaveri Microbiology Center, Prof. Brien Holden Eye Research Center, Hyderabad Eye Research Foundation, L.V. Prasad Eye Institute, L.V. Prasad Marg, Banjara Hills, Hyderabad 500-034, India.
Curr Eye Res. 2004 Aug-Sep;29(2-3):209-13. doi: 10.1080/02713680490504911.
To evaluate three different diagnostic tests against the gold standard of viral isolation, in the diagnosis of HSV-1 keratitis.
Corneal scrapings from 170 patients with clinically suspected HSV keratitis were tested by; 1) Giemsa staining procedure for the presence of multinucleated giant cells and lymphocytes, 2) immunofluorescence assay for HSV-1 antigen, 3) polymerase chain reaction (PCR) for HSV-1 DNA and 4) virus isolation by shell vial culture in SIRC (Rabbit corneal epithelial cell line). The results of the former three tests were compared among 14 cases that were culture positive and 156 cases that were culture negative for HSV-1.
The sensitivity of PCR was 100%, while IFA and Giemsa had sensitivities of 85.7% and 57.1% respectively. The specificity of PCR, IFA and Giemsa were found to be 67.9%, 85.3% and 85.9% respectively.
In the present study, a combination of PCR and immunofluorescence assay appears to be the most suitable choice of tests for diagnosis of HSV-1 keratitis, while detection of MNGC by Giemsa staining procedure may give us a presumptive diagnosis of suspected viral infection.
针对单纯疱疹病毒1型（HSV-1）角膜炎的诊断，评估三种不同诊断试验相对于病毒分离金标准的情况。
对170例临床疑似HSV角膜炎患者的角膜刮片进行检测，方法如下：1）吉姆萨染色法检测多核巨细胞和淋巴细胞；2）HSV-1抗原免疫荧光检测法；3）HSV-1 DNA聚合酶链反应（PCR）；4）通过SIRC（兔角膜上皮细胞系）的空斑小瓶培养进行病毒分离。比较前三项检测在14例HSV-1培养阳性和156例HSV-1培养阴性病例中的结果。
PCR的敏感性为100%，而免疫荧光检测法（IFA）和吉姆萨染色法的敏感性分别为85.7%和57.1%。发现PCR、IFA和吉姆萨染色法的特异性分别为67.9%、85.3%和85.9%。
在本研究中，PCR和免疫荧光检测法联合似乎是诊断HSV-1角膜炎最合适的检测选择，而吉姆萨染色法检测多核巨细胞可能为疑似病毒感染提供初步诊断。
