title: Evidence for persistence of adenovirus in the tear film a decade following conjunctivitis.
abstract: Chronic papillary conjunctivitis has been described following adenoviral conjunctivitis. It is unknown however, how long adenovirus is able to persist in the tear film and conjunctiva. To determine if adenovirus persists in the ocular surface following adenoviral conjunctivitis, 304 patients with a history of adenovirus conjunctivitis from whom an adenovirus had been isolated 10 years previously were sent a questionnaire regarding persistent or recurrent symptoms and were invited to attend. Patients were examined and samples of tears and conjunctival cells were collected from both eyes using tear film washes, filter paper, and swabs, the latter for virus isolation. Extracted DNA from the ocular samples was amplified using primers for herpes simplex virus (thymidine kinase) and adenovirus (hexon) genes. Adenovirus amplicons were sequenced and compared to original serotype. Thirty patients attended, 19 of whom had persistent papillary conjunctivitis. Evidence of adenovirus DNA was detected in 17 of 30 patients, 15 of whom also had evidence of a chronic papillary conjunctivitis. Adenovirus DNA was significantly associated with papillary conjunctivitis (P = 0.03). Adenovirus amplicons were successfully sequenced from six patients. Four patients harbored type 3 adenovirus, the same serotype with which they were infected originally 10 years previously. Two patients were infected originally with adenovirus serotype 3 but the current serotype was type 4. Infection of the ocular surface with adenovirus may predispose to the development of a persistent or recurrent conjunctivitis, the presence of which, appears to be associated with evidence of long term persistence of adenovirus DNA.
authors.affiliation: St. Paul's Eye Unit, 8Z Link, Royal Liverpool University Hospital, Prescot Street, Liverpool, United Kingdom. Stephen.kaye@rlbuht.nhs.uk
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Kaye
authors.forename: Marianne
authors.initials: M
authors.lastname: Lloyd
authors.forename: Helen
authors.initials: H
authors.lastname: Williams
authors.forename: Conrad
authors.initials: C
authors.lastname: Yuen
authors.forename: James A
authors.initials: JA
authors.lastname: Scott
authors.forename: Niall
authors.initials: N
authors.lastname: O'Donnell
authors.forename: Mark
authors.initials: M
authors.lastname: Batterbury
authors.forename: Paul
authors.initials: P
authors.lastname: Hiscott
authors.forename: Charles A
authors.initials: CA
authors.lastname: Hart
mesh_terms: D000258:Adenovirus Infections, Human / Q000821:virology*; D000260:Adenoviruses, Human / Q000302:isolation & purification; D003236:Conjunctivitis, Viral / Q000821:virology*; D006801:Humans; D007637:Keratoconjunctivitis / Q000821:virology*; D013666:Tears / Q000821:virology*; D013997:Time Factors