Adenoviral Ocular Isolates Demonstrate Serotype-Dependent Differences in In Vitro Infectivity Titers and Clinical Course

Roba, L A; Kowalski, Rose; Gordon, Alun; Romanowski, Eric G.; Gordon, Y Jerold

doi:10.1097/00003226-199507000-00007

Cited by 18 publications

(13 citation statements)

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“…Indeed, the large variation in clinical presentations encountered may have been due to the different serotypes of adenovirus involved. 17 In our audit, patients who presented with severe unilateral adenoviral disease, for example, severe chemosis, pseudoproptosis, severe periocular pain, had a higher rate of misdiagnosis/ differential diagnosis than those presenting with bilateral 'classical' symptoms and signs, for example, mild bilateral conjunctivitis following prodromal symptoms. Consequently, these patients can undergo unnecessary, invasive investigations and hospitalisation, with the correct diagnosis only being made after confirmation from the virology department.…”

Section: Discussionmentioning

confidence: 71%

Epidemic kerato-conjunctivitis—do outbreaks have to be epidemic?

Cheung

Bremner

Chan

2003

Eye

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Purpose To study: the epidemiology of an outbreak of adenoviral keratoconjunctivitis in a UK teaching hospital; disease presentation and its effect on clinical diagnostic efficiency; patterns of viral transmission between staff and patients; the effectiveness of infection control procedures in minimising outbreaks.Methods Prospective/retrospective clinical audit and retrospective audit of virological culture results: all viral culture swabs taken during an outbreak of adenoviral keratoconjunctivitis were analysed. The case records of patients whose viral swabs were positive for adenoviral culture were traced.

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Section: Discussionmentioning

confidence: 71%

Epidemic kerato-conjunctivitis—do outbreaks have to be epidemic?

Cheung

Bremner

Chan

2003

Eye

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“…Ltd, Mumbai, India) followed by an incubation at 37˚C in a moist chamber for 30 minutes. After a final wash with PBS, cells were observed under the fluorescence microscope [14]. Cells showing green fluorescence either in the cytoplasm or in the nucleus were considered as positive (Figure 3a), while cells showing reddish hue due to the Evans blue counterstain used for the FITC-conjugated antibody dilution were considered as negative for the presence of adenoviral antigen (Figure 3b).…”

Section: Indirect Immunofluorescence Stainingmentioning

confidence: 99%

“…All these factors can directly impact the viral recovery rate and thus affect the sensitivity of the viral culture that has been traditionally considered to be the gold standard or reference test [9]. When the reference test is imperfect, the sensitivity and the specificity of an alternative test can be determined by Bayesian LCM statistical analysis which does not assume any test as perfect [13,14]. In this study, the actual sensitivity and specificity of the viral culture, as determined by Bayesian LCM statistical analysis, was 72.2% and 90.8% respectively, although they are traditionally considered to be 100%.…”

Section: Accuracy Of Viral Culturementioning

confidence: 99%

Investigational approach to adenoviral conjunctivitis: comparison of three diagnostic tests using a Bayesian latent class model

Sundaramurthy¹,

Dhodapkar

Kaliaperumal

et al. 2018

J Infect Dev Ctries

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Introduction: Highly contagious adenoviral conjunctivitis represents 15-70% of all conjunctivitis worldwide. Human adenovirus (hAdV) serotypes 3,4,7,8,19 and 37 contributes to 89% of all adenoviral conjunctivitis. Accurate and rapid diagnosis of adenoviral infections at serotype level could prevent misdiagnosis, spread of disease, unnecessary antibiotic use and increased treatment costs. Methodology: Sixty-two suspected viral conjunctivitis cases were recruited from November2013-January2015. Swabs collected from inferior palpebral conjunctiva and processed for viral culture (Hep2 cell line), immunofluorescence assay (IFA) and polymerase chain reaction (PCR) (targeting hexon gene). Serotype 3,4,7,8,19 and 37 identification was carried out with an optimized multiplex-PCR (based on hypervariable region of hexon gene) and confirmed by sequence analysis. Bayesian Latent Class Model (LCM) analysis was used to compare sensitivity and specificity of three tests. Results: Adenovirus was detected in 54.8% (34/62) of cases by combination of all three methods. Culture was positive in 23/34 cases (67.6%). PCR and IFA detected adenovirus in 24 (70.5%) and 21 (61.7%) cases respectively. LCM analysis revealed, sensitivity and specificity of PCR, Culture and IFA was 77.8% and 92.4%; 72.2% and 90.8%; 67.6% and 92.9% respectively. Serotyping by multiplex-PCR showed, two cases each were hAdV3 and hAdV4, 18 hAdV8 and two remained unidentified. Results of Multiplex-PCR and sequence analysis showed 100% concordance Conclusion: LCM analysis revealed, PCR is the most appropriate method for identification. Multiplex-PCR is a simple and rapid method (serotypes identification within two days); owing its short turnaround time and accuracy, it can be used as a diagnostic tool for surveillance of adenoviral keratoconjunctivitis.

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“…Infectivity and the clinical course of AKC are serotype dependent. 25 Cidofovir proved to be effective against adenovirus types 1, 5, and 6 in the rabbit model, 10,26 but a relative resistance of adenovirus type 19 to cidofovir application was reported. 22 Variants of adenovirus type 5 with different sensitivity to topical treatment with 0.5% cidofovir in the rabbit ocular model have been described by Araullo-Cruz et al 27 Consequently, the efficacy of cidofovir in patients might also be serotype dependent.…”

Section: Serotype Dependencymentioning

confidence: 99%

Topical Treatment of Acute Adenoviral Keratoconjunctivitis With 0.2% Cidofovir and 1% Cyclosporine

Hillenkamp

Reinhard²,

Ross³

et al. 2001

Arch Ophthalmol

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To evaluate the efficacy of 0.2% cidofovir eyedrops and 1% cyclosporine eyedrops administered 4 times daily (qid) to treat acute adenoviral keratoconjunctivitis.Methods: A randomized, controlled, double-masked study was conducted on 39 patients with acute adenoviral keratoconjunctivitis of recent onset. Patients were divided into 4 treatment groups: (1) cidofovir qid, (2) cyclosporine qid, (3) cidofovir+cyclosporine qid, and (4) sodium chloride qid (control). The diagnosis was confirmed using adenoviral polymerase chain reaction from conjunctival swabs. Duration of treatment was 21 days.Main Outcome Measures: Severity of conjunctival hyperemia, conjunctival chemosis, superficial punctate keratitis during treatment, and presence and severity of corneal subepithelial infiltrates were evaluated using a clinical score. Duration until subjective improvement of symptoms was recorded.Results: Subjective improvement of local symptoms was accelerated in the cyclosporine group. All other clinically relevant variables showed no statistically significant difference among the 4 treatment groups. Particularly, we did not find a difference in the frequency of corneal subepithelial infiltrates at the end of treatment.Conclusions: Use of cidofovir, cyclosporine, or both did not accelerate the improvement of clinical symptoms of acute adenoviral keratoconjunctivitis compared with the natural course of the infection as demonstrated by this pilot study. This might be because of the wide spectrum of the clinical course of the infection, low sensitivity to cidofovir, too low of a concentration of cidofovir, or early cessation of viral replication in the course of the infection. The effect of a higher concentration of topical cidofovir with and without cyclosporine requires investigation in a larger group of patients.

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Adenoviral Ocular Isolates Demonstrate Serotype-Dependent Differences in In Vitro Infectivity Titers and Clinical Course

Cited by 18 publications

References 0 publications

Epidemic kerato-conjunctivitis—do outbreaks have to be epidemic?

Epidemic kerato-conjunctivitis—do outbreaks have to be epidemic?

Investigational approach to adenoviral conjunctivitis: comparison of three diagnostic tests using a Bayesian latent class model

Topical Treatment of Acute Adenoviral Keratoconjunctivitis With 0.2% Cidofovir and 1% Cyclosporine

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