title: Time profile of viral DNA in aqueous humor samples of patients treated for varicella-zoster virus acute retinal necrosis by use of quantitative real-time PCR.
abstract: The objective of this study was to evaluate the kinetics of varicella-zoster virus (VZV) loads using quantitative PCR (qPCR) in patients treated for acute retinal necrosis (ARN). Six patients (52 ± 13 years old) with ARN syndrome were consecutively studied. Aqueous humor (AH) was sampled from both eyes of all patients for qPCR evaluation. The patients were treated with intravenous acyclovir and intravitreal injections of antiviral drugs. The mean follow-up time was 17.6 ± 16.4 months. Main outcome measures were the numbers of viral genome copies in the AH, assessed using real-time qPCR with hydrolysis probe technology with a threshold of detection of 200 copies/ml. Two main portions of the viral load curves were observed for each patient: a plateau phase (27.8 ± 24.9 days) and a decrease in the number of viral genome copies. The mean baseline viral load was 3.4 × 10(7) ± 4.45 × 10(7) copies/ml (6 × 10(6) to 1.2 × 10(8) copies/ml). The viral load decreased according to a logarithmic model, with a 50% reduction obtained in 3 ± 0.7 days. There was a significant viral load (>102 copies/ml) at 50 days after the onset of treatment, despite antiviral drugs. qPCR use demonstrated reproducible VZV DNA kinetics with a two-phase evolution: a plateau followed by a logarithmic decrease. These data suggest that high-dosage antiviral therapy administered for the conventional 10-day duration is insufficient for most patients. This series of patients responded with a similar decrease in viral load once treatment was initiated, and the data from these patients may be used to predict the responses of future patients.
authors: Department of Ophthalmology, CHU de Grenoble, University Hospital/Université Joseph Fourier-Grenoble 1, Grenoble, France.
authors: D
authors: D
authors: Bernheim
authors: R
authors: R
authors: Germi
authors: M
authors: M
authors: Labetoulle
authors: J P
authors: JP
authors: Romanet
authors: P
authors: P
authors: Morand
authors: C
authors: C
authors: Chiquet
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D001082:Aqueous Humor / Q000821:virology*; D004279:DNA, Viral / Q000235:genetics* / Q000302:isolation & purification; D005260:Female; D006562:Herpes Zoster / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D060888:Real-Time Polymerase Chain Reaction; D015882:Retinal Necrosis Syndrome, Acute / Q000188:drug therapy / Q000821:virology*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral
references: Am J Ophthalmol. 2005 Sep;140(3):509-16
references: 16196117
references: Am J Ophthalmol. 1997 Feb;123(2):255-7
references: 9186134
references: Int Ophthalmol. 2009 Jun;29(3):199-201
references: 18297242
references: Am J Ophthalmol. 1994 May 15;117(5):663-7
references: 8172275
references: Am J Ophthalmol. 1991 Sep 15;112(3):250-5
references: 1882936
references: Ophthalmology. 2006 Dec;113(12):2259-61
references: 16996614
references: Antimicrob Agents Chemother. 2003 Jul;47(7):2351-3
references: 12821497
references: Curr Opin Infect Dis. 2003 Dec;16(6):601-6
references: 14624112
references: Ophthalmology. 2009 Oct;116(10):1971-5.e2
references: 19592111
references: Br J Ophthalmol. 2008 Apr;92(4):505-8
references: 18245272
references: J Clin Microbiol. 2000 Jul;38(7):2638-42
references: 10878056
references: Br J Ophthalmol. 2007 Nov;91(11):1452-5
references: 17504853
references: Jpn J Ophthalmol. 2005 Jan-Feb;49(1):64-5
references: 15692781
references: Clin Transplant. 2002 Apr;16(2):107-12
references: 11966780
references: Graefes Arch Clin Exp Ophthalmol. 1998 Oct;236(10):747-52
references: 9801889
references: Acta Ophthalmol. 2012 Aug;90(5):456-60
references: 20553233
references: J Med Virol. 1993 Oct;41(2):170-3
references: 8283180
references: Br J Ophthalmol. 1997 Nov;81(11):976-9
references: 9505822
references: Semin Ophthalmol. 2008 Jul-Aug;23(4):285-90
references: 18584565
references: J Clin Virol. 2004 Mar;29(3):206-9
references: 15002491
references: Curr Opin Ophthalmol. 2001 Jun;12(3):191-5
references: 11389345
references: Arch Ophthalmol. 2002 Nov;120(11):1534-9
references: 12427068
references: J Clin Virol. 2007 Mar;38(3):254-9
references: 17280866
references: Ophthalmology. 2007 Apr;114(4):756-62
references: 17184841
references: Br J Ophthalmol. 1993 Sep;77(9):572-3
references: 8218055
references: J Infect Dis. 1998 Sep;178(3):626-35
references: 9728529
references: J Virol Methods. 2007 Dec;146(1-2):147-54
references: 17673304
references: Ophthalmology. 1986 Mar;93(3):296-300
references: 3703498
references: Am J Ophthalmol. 2004 May;137(5):872-9
references: 15126152
references: Invest Ophthalmol Vis Sci. 2010 Sep;51(9):4703-6
references: 20393107
references: J Clin Microbiol. 2005 Jul;43(7):3290-6
references: 16000450
references: Am J Ophthalmol. 2000 Jun;129(6):811-3
references: 10926999
references: Ophthalmology. 2007 Feb;114(2):307-12
references: 17123607
references: J Clin Microbiol. 2003 Apr;41(4):1565-8
references: 12682146
references: Bone Marrow Transplant. 2006 Jul;38(1):41-6
references: 16715108
references: Am J Transplant. 2009 Feb;9(2):258-68
references: 19178413
references: J Clin Microbiol. 1999 Sep;37(9):2804-7
references: 10449456
references: Retina. 2010 May;30(5):795-800
references: 20057342
references: Invest Ophthalmol Vis Sci. 2009 Dec;50(12):5601-8
references: 19608530
references: Eye (Lond). 2012 Feb;26(2):237-40
references: 22173076
references: Ophthalmology. 2010 Apr;117(4):818-24
references: 20079537
references: J Clin Microbiol. 2001 Feb;39(2):772-5
references: 11158149
references: Surv Ophthalmol. 1991 Mar-Apr;35(5):327-43
references: 2038718
references: J Clin Microbiol. 2000 Jun;38(6):2447-9
references: 10835029
references: Ophthalmology. 2010 Mar;117(3):556-60
references: 20031221