Journal
JOURNAL OF CLINICAL VIROLOGY
Volume 147, Issue -, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.jcv.2022.105079
Keywords
Epstein-Barr Virus; Uveitis; Polymerase chain reaction; Acyclovir; Ganciclovir
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There are still many research challenges and unanswered questions in relation to Epstein-Barr virus-associated uveitis, including the presence of viral DNA in asymptomatic patients, its pathogenicity in uveitis eyes, and the effectiveness of antiviral therapy. A retrospective review was conducted on data collected from a Thai hospital's Ophthalmology Department, revealing that patients with EBV infection may also be co-infected with other pathogens. Most cases showed clinical improvement with systemic acyclovir and ganciclovir treatment, and the majority of patients achieved a cure for the EBV infection.
Background: There are still many research challenges and unanswered questions in relation to Epstein-Barr virus-associated uveitis. These include the presence of Epstein-Barr virus (EBV) DNA in asymptomatic patients, its pathogenicity in the uveitis eye, and the role of antiviral therapy for EBV-associated intraocular inflammation. Methods: This was a retrospective review of prospectively collected data from the Ophthalmology Department, Rajavithi Hospital between 2015 and 2020. A qualitative assay using multiplex real-time PCR was performed to detect pathogen genes from specimens obtained from a total of 344 patients. The main outcome measure was treatment success defined by clinical improvement and absence of viral DNA confirmed by PCR. Results: Of the 35 cases, 24 with complete data were enrolled in the study, including 22 with post-treatment PCR results. Sixty-seven percent were HIV-infected, and other plausible causes or coinfection with other pathogens were found in 75% of patients. Cytomegalovirus (38%) was the most common co-infecting pathogen. The most commonly employed regimen was a combination of systemic acyclovir and intravitreal ganciclovir injection (58%). Of the 22 cases who had post-treatment PCR results, absence of detection of the virus by PCR in the intraocular fluid after treatment was demonstrated in 73% of patients. Conclusion: Patients with EBV infection can be simultaneously co-infected with other pathogens. Systemic acyclovir and ganciclovir achieved clinical improvement in most cases, and EBV infection was cured in the majority of patients.
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