Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA.
Clinical Microbiology Laboratory, University of Pittsburgh Medical Center, Pittsburgh, PA.
Am J Clin Pathol. 2018 Oct 24;150(6):522-532. doi: 10.1093/ajcp/aqy088.
To determine a quantitative herpes simplex virus (HSV) DNA threshold in lower respiratory tract specimens that correlates with positive viral culture and clinical outcomes.
Bronchoalveolar lavage and bronchial wash samples from 53 HSV culture-positive and 61 culture-negative matched controls were tested using HSV-1 and HSV-2 quantitative polymerase chain reaction (qPCR).
Median viral culture turnaround time was 21.8 days and 9.9 days for culture-negative and culture-positive specimens, respectively. Using an HSV-1 viral load threshold of 1.62 × 103 copies/mL, there was 93% agreement with viral culture. An HSV-1 viral load ≥1.3 × 104 copies/mL was associated with worse clinical outcome compared to a viral load <1.3 × 104 copies/mL (hazard ratio [HR] = 4.27, P = .017), and there was a trend of worse outcome compared to patients with undetectable HSV-1 DNA (HR = 1.60, P = .056).
qPCR has clinical utility for rapid accurate identification of HSV-1 in lower respiratory tract specimens.
确定与病毒培养阳性和临床结局相关的下呼吸道标本中单纯疱疹病毒（HSV）DNA 的定量阈值。
对 53 例 HSV 培养阳性和 61 例培养阴性的匹配对照者的支气管肺泡灌洗液和支气管冲洗液样本，采用 HSV-1 和 HSV-2 定量聚合酶链反应（qPCR）进行检测。
病毒培养阴性和阳性标本的培养周转时间中位数分别为 21.8 天和 9.9 天。使用 HSV-1 病毒载量阈值为 1.62×103 拷贝/mL 时，与病毒培养的符合率为 93%。与病毒载量 <1.3×104 拷贝/mL 相比，HSV-1 病毒载量≥1.3×104 拷贝/mL 与更差的临床结局相关（危险比[HR] = 4.27，P =.017），与 HSV-1 DNA 检测不到的患者相比，也存在结局更差的趋势（HR = 1.60，P =.056）。
qPCR 在下呼吸道标本中对 HSV-1 的快速准确鉴定具有临床应用价值。
