The evaluation of diagnostic efficiency for stromal herpes simplex keratitis by the combination of tear HSV-sIgA and HSV-DNA

• Published in: Graefe's archive for clinical and experimental ophthalmology 2017-07, Vol.255 (7), p.1409-1415
• Main Authors: Qiu, Jini, Huang, Feifei, Wang, Zhujian, Xu, Jianjiang, Zhang, Chaoran
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Cornea; Corneal Stroma - diagnostic imaging; Corneal Stroma - pathology; Corneal Stroma - virology; Deoxyribonucleic acid; DNA; DNA, Viral - analysis; Enzyme-Linked Immunosorbent Assay; Eye Infections, Viral - diagnosis; Eye Infections, Viral - metabolism; Eye Infections, Viral - virology; Female; Herpes simplex; Herpes viruses; Humans; Immunoglobulin A; Immunoglobulin A, Secretory - metabolism; Immunoglobulin G; Immunoglobulin M; Infant; Infant, Newborn; Keratitis; Keratitis, Herpetic - diagnosis; Keratitis, Herpetic - metabolism; Keratitis, Herpetic - virology; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Polymerase Chain Reaction; Reproducibility of Results; Retrospective Studies; Simplexvirus - genetics; Tears - metabolism; Tears - virology; Young Adult
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-017-3653-6

Purpose To assess the differential diagnostic values for stromal herpes simplex keratitis (HSK) by using tear HSV-sIgA, tear HSV-DNA, and the combination. Methods Tear samples for both eyes and the paired serum were collected from 187 stromal HSK and 56 controls. Enzyme-linked immune sorbent assay (ELISA) was used to analyze the tear HSV-sIgA and serum IgG/IgM/IgA. The levels of tear HSV-DNA were measured by polymerase chain reaction (PCR). Results The positive rates for tear HSV-sIgA and HSV-DNA were 36.90% and 10.96% respectively in stromal HSK patients. Twelve showed positivity for both sIgA and DNA, while 46 cases were positive for sIgA or DNA. The sensitivity, specificity, PPV, and NPV for simultaneous measurement were 39.73%, 98.21%, 98.31%, and 38.46%. The total negative conversion rate of sIgA was 95.71%. Conclusions The diagnostic efficiency of HSV-sIgA only is nearly equal to the combination of HSV-sIgA and HSV-DNA, and the positive result is optimum to achieve a reliable diagnosis of stromal HSK even in atypical or unsuspected cases.