Use of PCR versus ELISA for detection of Herpes Simples Virus –1 genome in patients with diagnosis of herpetic keratitis.

Abstract

Abstract: : Purpose:Identification of Herpes Simplex Virus –1 genome and viral antigens in patients with clinical diagnosis of herpetic keratitis Methods:Tear samples and corneal scrapings of patients with epithelial or stromal herpetic keratitis were analized by polimerase chain reaction (PCR–genome) and ELISA (HERPCHECK detection of capsid antibodies) Results:Samples from 41 patients with clinical diagnosis of herpetic keratitis and 5 healthy subjects as controls were analyzed. 9 patients were diagnosed as having epithelial keratitis, 20 had stromal keratitis, and 12 were classified as undetermined , from which only ten had inflammatory activity. Viral antigens and genome were detected in all subjects with epithelial keratitis but only in one case of stromal nectrozing form where viral DNA was identified but the ELISA was negative. Only 40 % of the samples belonging to the undetermined group were positive for either viral genome or antigens. Conclusions:If the presence of herpetic epithelial keratitis with inflammatory activity is suspected, we suggest the confirmation of HSV–1 by PCR which is less time consuming and highly sensitive compared to the ELISA. A correlation should be established between ELISA , PCR and the replicative sate of the virus as a guide for the treatment strategy. In the case of stromal keratitis without inflammatory activity there was no detection of the viral DNA or antigens.

Keywords: herpes simplex virus • detection • cornea: clinical science