Detección del genoma y antígenos del Herpes Simplex Virus-1 en pacientes con queratitis herpética

Objective: To detect the genome and Herpes Simplex virus-1 antigens in ocular samples of patients with herpetic keratitis. Materials and methods: We analyzed by polymerase chain reaction (PCR-genome) and ELISA (HERPCHEK to detect capsid antibodies) tear and corneal samples from patients with epithelial or stromal herpetic keratitis. Results: We included 41 patients with the presumptive diagnosis of ocular herpetic disease and 5 controls without herpes. We detected the presence of genome and antigens of HSV in 100% of cases with epithelial keratitis (9 patients), there was a complete absence of HSV genome and antigens in all samples of stromal keratitis, except in one case with the diagnosis of necrotizing stromal keratitis we found the genome. Twelve patients were classified as doubtful herpetic keratitis and we detected the HSV in 40% of cases with active inflammation. Conclusions: In epithelial herpetic keratitis, we suggest that the presence of Herpes Simplex-1 be confirmed with PCR, given the superior sensitivity and practical approach when compared to the antigenic immunologic reaction. Also correlate the results of the PCR and ELISA with the replicative state of the virus. In the inactive stromal keratitis cases, neither the viral genome nor the antigens against the virus were detected.