Prevalence and clinical consequences of herpes simplex virus type 1 DNA in human cornea tissues

TitlePrevalence and clinical consequences of herpes simplex virus type 1 DNA in human cornea tissues
Publication TypeJournal Article
Year of Publication2009
AuthorsRemeijer L, Duan R, van Dun JM, Wefers Bettink MA, Osterhaus AD, Verjans GM
JournalJ Infect Dis
Pagination11 - 9
Date PublishedJul 1
ISSN0022-1899 (Print) 0022-1899 (Linking)
Accession Number19476433
KeywordsCohort Studies, Cornea / surgery / *virology, Corneal Diseases / surgery / virology, Corneal Transplantation / methods, DNA, Viral / *genetics, Graft Survival, Herpes Zoster / surgery / virology, Herpesvirus 1, Human / *genetics, Herpesvirus 2, Human / genetics, Herpesvirus 3, Human / genetics, Humans, Keratoplasty, Penetrating, Retrospective Studies, Treatment Failure

BACKGROUND: We determined the prevalence and clinical consequences of herpes simplex virus (HSV) type 1 (HSV-1), HSV type 2 (HSV-2), and varicella-zoster virus (VZV) in cornea tissues obtained after penetrating keratoplasty (PKP) was performed. METHODS: The excised corneas of 83 patients with a history of herpetic keratitis (HK; hereafter referred to as "patients with HK") and 367 patients without a history of HK (hereafter referred to "patients without HK") were analyzed by real-time polymerase chain reaction (PCR) and virus culture for the presence of HSV-1, HSV-2, and VZV. In addition, 273 post-PKP donor corneoscleral rims were analyzed. The medical records of the transplant patients were reviewed to determine the risk factors influencing intracorneal viral load and graft survival. RESULTS: HSV-1 was the most prevalent herpesvirus. Both the prevalence of HSV-1 and the HSV-1 DNA load were higher in the corneas of patients with HK than in those of patients without HK. The HSV-1 DNA load in the corneas of patients with HK correlated with age, the recurrence-free interval, cornea neovascularization, steroid treatment before PKP, and disease severity. Herpesvirus DNA was detected in 2 of 273 corneoscleral rims. Graft survival was inversely correlated with the corneal HSV-1 DNA load in patients with HK. CONCLUSIONS: The data presented in this study argue for the implementation of real-time HSV-1 PCR to analyze the excised corneas of patients with HK, to improve post-PKP diagnosis and therapy. Screening of donor corneal tissues for herpesviruses is redundant to prevent newly acquired post-PKP HK.

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