Polymerase Chain Reaction and Goldmann-Witmer Coefficient Testing in the Diagnosis of Infectious Uveitis in HIV-Positive and HIV-Negative Patients in South Africa

Ocul Immunol Inflamm. 2019;27(2):189-196. doi: 10.1080/09273948.2017.1407802. Epub 2017 Dec 28.

Abstract

Purpose: To use polymerase chain reaction (PCR) and Goldmann-Witmer coefficient (GWC) calculation to diagnose infectious uveitis.

Methods: Prospective cross-sectional study.

Results: Twenty-seven of 106 patients had positive PCR and/or GWC results on aqueous humor (AH) sampling and 15 of 27 (55.6%) were HIV-positive. Patients with non-anterior uveitis (NAU) were more likely to be HIV+ (p = 0.005). More than 1 possible pathogen was identified in 9 of 27 patients of whom 7 were HIV+. The final clinical diagnosis was discordant with AH findings in 9 of 27 cases. A positive EBV PCR result was associated with a discordant diagnosis (p = 0.001). All cases of herpetic anterior uveitis (42.9% HIV+) tested PCR-/GWC+ while all cases of herpetic NAU tested PCR+/GWC- (83.3% HIV+). All rubella virus cases were PCR+/GWC+.

Conclusion: PCR is useful to diagnose herpetic NAU in HIV+ patients while GWC is useful to diagnose herpetic anterior uveitis.

Keywords: Diagnosis; Goldmann-Witmer coefficient; HIV; South Africa; infectious uveitis; polymerase chain reaction.

MeSH terms

  • Adult
  • Aqueous Humor / virology
  • Cross-Sectional Studies
  • DNA, Viral / analysis*
  • Eye Infections, Viral / diagnosis*
  • Eye Infections, Viral / epidemiology
  • Eye Infections, Viral / virology
  • Female
  • Follow-Up Studies
  • HIV / genetics*
  • HIV Seronegativity*
  • HIV Seropositivity*
  • Humans
  • Incidence
  • Male
  • Prospective Studies
  • Real-Time Polymerase Chain Reaction / methods*
  • South Africa
  • Uveitis / diagnosis*
  • Uveitis / epidemiology
  • Uveitis / virology

Substances

  • DNA, Viral