Chen Siyuan, Peng Qi, Wang Hailuo, Xie Jinglin, Cao He, Xu Xiaohong
Department of Ophthalmology, Air Force Hospital of Eastern Theater Command, Nanjing, Jiangsu, 210002, People's Republic of China.
Department of Ophathalmology, Shenzhen People's Hospital, Southern University of Science and Technology; The second Clinical Medical College, Jinan University, Shenzhen, 518020, People's Republic of China.
Infect Drug Resist. 2025 Jun 19;18:3063-3070. doi: 10.2147/IDR.S527047. eCollection 2025.
Ocular infections caused by (HSV) and (VZV) are major contributors to vision impairment worldwide, necessitating accurate and accessible diagnostic tools. This study aimed to investigate the seroprevalence of HSV and VZV infections in patients with suspected ocular infections and to evaluate associated risk factors.
We conducted a cross-sectional study using enzyme-linked immunosorbent assay (ELISA) to detect antibodies against HSV and VZV in patients with ocular symptoms. Serological data were stratified into IgG and IgM positivity to differentiate past from active infections. Serological data were stratified into IgG (indicative of past infection) and IgM (suggestive of active infection) positivity to differentiate past from active infections. A total of 200 patients were enrolled, and demographic and clinical data were collected, including age, history of ocular surgery, and immunosuppressive therapy.
The overall seroprevalence for HSV was 14%, and for VZV, it was 9%. Age was a significant risk factor for both infections, with individuals over 50 years (mean age of 48.9 ± 13.8 years) showing increased seropositivity ( < 0.001). The predominant ocular manifestation for HSV was keratitis (69%), while VZV infections were most commonly associated with conjunctivitis (62%). We identified a strong association between ocular surgery and HSV/VZV seropositivity ( < 0.001), and immunosuppressive therapy was significantly linked with VZV seropositivity ( < 0.001).
ELISA-based antibody detection proved effective in identifying both past and active HSV and VZV infections. The findings highlight age, ocular surgery, and immunosuppressive therapy as key risk factors for these infections. Given the diagnostic limitations of ELISA, future studies should incorporate molecular diagnostics for enhanced accuracy. These findings support the use of ELISA for screening high-risk populations, although adjunct molecular testing may improve diagnostic accuracy. Early serological screening in high-risk patients could aid in the timely detection and management of ocular herpesvirus infections.
单纯疱疹病毒（HSV）和水痘-带状疱疹病毒（VZV）引起的眼部感染是全球视力损害的主要原因，因此需要准确且易于获得的诊断工具。本研究旨在调查疑似眼部感染患者中HSV和VZV感染的血清流行率，并评估相关危险因素。
我们进行了一项横断面研究，使用酶联免疫吸附测定（ELISA）检测有眼部症状患者体内抗HSV和VZV的抗体。血清学数据分为IgG和IgM阳性，以区分既往感染和活动性感染。血清学数据分为IgG（指示既往感染）和IgM（提示活动性感染）阳性，以区分既往感染和活动性感染。共纳入200例患者，并收集了人口统计学和临床数据，包括年龄、眼部手术史和免疫抑制治疗情况。
HSV的总体血清流行率为14%，VZV为9%。年龄是这两种感染的重要危险因素，50岁以上（平均年龄48.9±13.8岁）的个体血清阳性率更高（P<0.001）。HSV最主要的眼部表现是角膜炎（69%），而VZV感染最常与结膜炎相关（62%）。我们发现眼部手术与HSV/VZV血清阳性之间存在密切关联（P<0.001），免疫抑制治疗与VZV血清阳性显著相关（P<0.001）。
基于ELISA的抗体检测被证明在识别既往和活动性HSV及VZV感染方面有效。研究结果突出了年龄、眼部手术和免疫抑制治疗是这些感染的关键危险因素。鉴于ELISA的诊断局限性，未来研究应纳入分子诊断方法以提高准确性。这些发现支持使用ELISA对高危人群进行筛查，尽管辅助分子检测可能会提高诊断准确性。对高危患者进行早期血清学筛查有助于及时发现和管理眼部疱疹病毒感染。
