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Diane Bernheim, Raphaelle Germi, Patrice Morand, Marc Labetoulle, Jean-Paul Romanet, Christophe Chiquet; Time Profile Of Viral Dna In Aqueous Humor Of Patients Treated For Vzv Acute Retinal Necrosis Using Quantitative Real-time Pcr. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1198.
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Real-time quantitative polymerase chain reaction (qPCR) has been introduced to provide an accurate quantification of viral genome copies in viral retinitis diagnosis as acute retinal necrosis syndrome (ARN). Now we do not known whether viral DNA kinetics during systemic treatment and/or intravitreal therapy11 is predictable for all patients.This case series objective was to assess ARN VZV DNA load evolution after systemic/intravitreal antiviral treatment and to evaluate qPCR contribution to patients monitoring with VZV acute retinal necrosis.
This retrospective study was conducted on a consecutive series of six patients with ARN syndrome.All eyes were sampled aqueous humor used for qPCR evaluation before antiviral intravitreal injection (IVT). Multiplex PCR allowed internal controls. . Slope of viral DNA decrease over time used one segment of the curve illustrating the numbers of VZV genome copies . VZV DNA were modeled with logarithmic decay curve
All patients HIV-negative had extensive retinitis . Patients were given aciclovir intravenously with antiviral IVT. Treatment duration was adapted to inflammation course and patient drug tolerance.According to the kinetics defined for each patient (increase, plateau, and decrease), two main portions of the DNA curves were defined for each patient: a plateau phase followed by a phase in which the viral DNA amount declined. 108 /ml). We found no correlation between initial viral load and plateau duration , treatment efficacy onset, or age . Viral load decreased following an exponential model . We found no correlation between biological plateau duration and healing onset .
QPCR use demonstrated a VZV DNA reduction course with virus clearance kinetics including plateau and logarithmic reduction. Data suggest that conventional 10 days duration high-dose therapy is insufficient . Since all the patients in this series seemed to respond with similar kinetics at viral load decline onset, VZV DNA load modeling could also be useful to predict new patients viral load course.
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