Comparative sensitivity of a cultural test and the complement fixation test in the diagnosis of adenovirus ocular infection.

Abstract

SUMMARY The sensitivity of human embryonic kidney (HEK) cell culture and the complement fixation test (CFT) The ocular morbidity associated with adenovirus infections varies considerably. These eye infections constitute a major economic problem owing to the loss of a considerable number of working days each year. Sporadic cases of acute follicular conjunctivitis and keratoconjunctivitis caused by various serotypes of adenovirus are common entities. Adenovirus serotypes 3, 4, 7, 8, and 19 particularly are responsible for outbreaks of the disease in hospitals, factories, and schools (Editorial, 1977).Several laboratory tests are available for the diagnosis of adenovirus ocular infection. Cell cultures for virus isolation and the complement fixation test (CFT) for detection of antibody to adenovirus group antigen are routine laboratory procedures which are extensively used for the diagnosis of ocular infection.In this paper we compare the sensitivity of a primary human embryonic kidney (HEK) cell culture system with the complement fixation test for the diagnosis of adenovirus infection of the eye. The optimum time for collection of specimens Correspondence to Dr S. Darougar, Institute of Ophthalmology, Judd Street, London WCIH 9QS, to obtain the highest positivity rate by each test is discussed. Materials and methods SELECTION OF PATIENTSPatients attending the clinic with moderate to severe follicular conjunctivitis or keratoconjunctivitis clinically suggestive of an adenovirus infection were included in this study. CULTURAL TESTSwabbings collected from different areas of the conjunctiva (Darougar and Jones, 1971) were placed in plastic capsules containing 2SP transport medium (Gordon et al., 1969) with additional fetal bovine serum, and stored at -70°C until required.Each specimen was inoculated into 2 tubes of HEK cells and examined at regular intervals for the presence of cytopathic effect (CPE) for up to 21 days (McSwiggan et al., 1975). The isolates were identified and serotyped by standard methods. SEROLOGICAL TESTSerum collected by venepuncture was tested by a complement fixation test (Bradstreet and Taylor,

Pathogenesis and management of adenoviral keratoconjunctivitis

“…The first method of identification is the isolation of the virus in cell cultures, using HEK cell cultures, or through the use of complement fixation test. 115 , 116 In HEK cell cultures, samples are obtained from the conjunctiva of affected patients and inoculated into HEK cells to analyze structural changes to host cells from viral invasion. Complement fixation test methods involve blood samples tested for the detection of antibodies related to AdV infection.…”

“…Side-by-side comparison of these two methods indicates superior sensitivity with HEK cell culture testing. 115 The limitation is the timing of laboratory testing, in that it takes ~1–2 weeks for results to be made available. 116 …”