Vitreous fluid sampling and viral genome detection for the diagnosis of viral retinitis in patients with AIDS

Abstract

Cytomegalovirus (CMV) causes severe necrotizing retinitis in patients with the acquired immune deficiency syndrome (AIDS) and other herpesviruses have been implicated in the acute retinal necrosis syndrome (ARN), seen in both the immunocompetent and the immunosuppressed. At present the diagnosis of viral retinitis relies solely on clinical appearances. In order to assess whether the detection of herpesvirus-specific DNA in cell-free vitreous biopsy samples could be useful in the early diagnosis of viral retinitis, vitreous fluid samples were taken from 100 patients. Fifty patients had AIDS as defined by the Centers for Disease Control, (MMWR 36 (suppl 1S):1S-15S, 1987) and retinal disease. The remainder were not known to be HIV infected and had no clinical evidence of retinal infection. Each sample was tested for the presence of CMV, herpes simplex virus 1 (HSV-1), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), and human herpesvirus 6 (HHV6), by amplification of viral DNA using a sensitive and specific nested polymerase chain reaction (PCR). The presence of detectable CMV or VZV DNA was clearly associated with clinical disease whereas the presence of HSV-1, EBV, and HHV6 sequences were not. Clinical discrimination between CMV- and VZV-associated retinitis was greatly enhanced when the PCR results were taken into consideration.

PCR with the Aqueous Humor, Blood Leukocytes and Vitreous of Patients Affected by Cytomegalovirus Retinitis and Immune Recovery Uveitis

“…As mentioned above, we attribute this low sensitivity to the use of ganciclovir by these patients. Despite the small number of participants, our data suggest that PCR in the aqueous humor could be used either to confirm the etiology or to check the evolution after treatment of CMV retinitis, as suggested by other authors [5, 6, 7, 8]. Aqueous humor collection could be easily done by a low-risk paracentesis of the anterior ocular chamber [16].…”

Acute otitis media associated with cytomegalovirus infection in infants and children

“…Briefly, viral DNA was extracted from 100 mL aliquots of samples with a QIAamp DNA Mini Kit (QIAGEN, Hilden, Germany) and PCR was done to amplify the glycoprotein B gene of CMV [7]. The primer pair used for the first PCR of the glycoprotein B gene was 5 0 -GAGGACAACGAAATCCTGTTGGGCA-3 0 and 5 0 -GTCGACGGTGGAGATACTGCTGAGG-3 0 , while the primers for the nested PCR were 5 0 -ACCACCG-CACTGAGGAATGTCAG-3 0 and 5 0 -TCAATCATGCGTTT-GAGGAGGTA-3 0 .…”

Acute bilateral uveitis associated with an active human herpesvirus-6 infection

“…3 The herpes viruses, which include herpes simplex virus (HSV), human cytomegalovirus (HCMV) and varicella-zoster virus (VZV), are implicated in ocular diseases in both immunocompetent and immunosuppressed patients, whereas HHV-6 is less frequently involved. 4 This article reports a case of a patient presenting with bilateral uveitis from whom HHV-6 DNA was detected both in aqueous fluid and cerebrospinal fluid (CSF).…”