Monitoring of visual field over 6 months after active ocular toxoplasmosis.

PURPOSE: To prospectively report the perimetric defects during a 6-month follow-up (FU) in patients with initially active ocular toxoplasmosis (OT). METHODS: Twenty-four patients were studied, including 11 eyes with chorioretinal toxoplasmosis proven with a positive aqueous humor sample and 13 eyes with a biologically unproven, chorioretinal lesion. Automated 24-2 SITA-Standard visual fields were performed at baseline, at the first, and sixth months of FU. A composite clinical severity score was calculated from visual acuity (VA), severity of vitreitis, chorioretinal lesion size, location of the lesion in zone 1, the presence of an initial macular or papillary edema, and long-term scarring. This provided a relative cutoff level of severity. Nine eyes out of the 24 eyes were considered severe (3 unproven and 6 proven OT). RESULTS: Initial and final visual field parameters (mean deviation [MD] and pattern standard deviation [PSD]) were significantly correlated (r = 0.873; p < 0.001, and r = 0.890; p < 0.001, respectively). During FU, only foveal threshold [FT] was correlated with VA at baseline (r = 0.48; p = 0.01) and at the 6-month FU visit (r = 0.547; p = 0.004). The MD initial predictive value of clinical severity was 0.739 according to the ROC curve. At baseline, severe and nonsevere OT exhibited no significant difference in term of MD (p = 0.06) and PSD (p = 0.1). During the FU, taking into account all the data, MD, PSD, visual function index [VFI], and FT were associated with the severity of toxoplasmosis (p = 0.018, 0.05, 0.016, and 0.02, respectively): the unproven group had a faster recovery of MD during FU (p = 0.05). CONCLUSION: Visual field parameters better reflected the chorioretinal destruction related to the toxoplasmosis lesion and the functional repercussions than VA alone. Interestingly, MD at presentation could be a discriminating factor of severity in active OT, and each visual field parameter follow-up could be a support to manage patients with active OT, especially in the severe group.

Biological autoimmunity screening in hepatitis C patients by anti-HepG2 lysate and anti-heat shock protein 70.1 autoantibodies.

Viruses require viral and cellular chaperones during their life cycle and interactions of these molecules with the immune system are probable during the infection. Thus, an anti-chaperone antibody response has been firstly investigated in hepatitis C patients in this paper. A HepG2-lysate antigen (90, 79, 72, 70, 62, 54 and 48 kDa) was assayed in sera from 59 (19F/40M) chronic hepatitis C patients without cirrhosis before therapy. Forty of them were positive for anti-HepG2 lysate antigen antibodies and this test may evaluate biological autoimmunity. Hsp70.1, Hsp90 and calreticulin levels were significantly higher in this antigen than in a control HepG2 antigen. Secondly, Hsp70.1 was identified as Hsp 70 kDa protein-1 by proteomic analysis and studied as a possible antibody target. Fourteen out of 59 patients were positive for anti-Hsp70.1 antibodies that were inversely correlated with alanine aminotransferase levels, the Metavir activity index and viraemia. Finally, for comparative purposes, 50 sera from systemic lupus erythematosus (SLE) patients have been tested: eight and 41 of them were positive for anti-Hsp70.1 and anti-HepG2 lysate antigen antibodies, respectively. Therefore, anti-Hsp70.1 autoantibodies may be produced and can partially lead to biological autoimmunity in chronic hepatitis C patients.