HSV-1 antigens and DNA in the corneal explant buttons of patients with non-herpetic or clinically atypical herpetic stromal keratitis.
BACKGROUND
Little is known about the role of HSV-1 in keratitis not primarily attributed to herpetic origin. This study therefore aimed to prospectively evaluate the corneal explant buttons of patients with non-herpetic or clinically atypical herpetic stromal keratitis (experimental group: non-HSK) for the presence of HSV-1 antigens and DNA, and to compare the findings with those from individuals with typical herpetic stromal keratitis (positive control group: HSK) or non-inflammatory degenerative keratopathy (negative control group).


METHODS
Corneal buttons derived from 51 patients with HSK, from 72 with non-HSK and from 30 with degenerative keratopathy were prospectively collected and subjected to immunohistochemical analysis for HSV-1 antigens and to HSV-1 DNA amplification.


RESULTS
In corneal buttons derived from patients with non-HSK, viral antigens were detected immunohistochemically in 8/72 cases and DNA amplified in 16/72. Corresponding values for the HSK group were 16/51 and 11/51. Taking viral antigen and DNA findings together, HSV-1 was detected in 18/72 (25%) patients with non-HSK and in 19/51 (37%) with HSK (p=0.2), but in only 2/30 (6%) individuals with non-inflammatory degenerative keratopathy.


CONCLUSIONS
Since the detection frequencies for HSV-1 antigens and DNA were comparable in the HSK and non-HSK groups, Herpes may play an underestimated and as yet undefined role in non-herpetic and clinically atypical herpetic stromal keratitis, either as a primary trigger of the disease or as a secondary contributor to it. In this category of individuals, early anti-herpetic therapy should be considered if patients do not respond in the expected manner to treatment for non-herpetic stromal keratitis.
Garweg
Justus Gerhard
JG
Department of Ophthalmology, University of Bern, Inselspital, 3010 Bern, Switzerland. justus.garweg@insel.ch
Russ
Christiane Elisabeth
CE
Schellhorn
Marc
M
Böhnke
Matthias
M
Halberstadt
Markus
M
D016022:Case-Control Studies; D003315:Cornea / Q000276:immunology / Q000378:metabolism; D003316:Corneal Diseases / Q000276:immunology / Q000378:metabolism / Q000821:virology; D003319:Corneal Stroma; D004279:DNA, Viral / Q000032:analysis*; D015488:HIV Antigens / Q000032:analysis*; D018259:Herpesvirus 1, Human / Q000235:genetics* / Q000276:immunology*; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007634:Keratitis / Q000276:immunology* / Q000378:metabolism / Q000821:virology; D016849:Keratitis, Herpetic / Q000276:immunology* / Q000378:metabolism / Q000821:virology; D009693:Nucleic Acid Hybridization; D013194:Staining and Labeling
D004279:DNA, Viral; D015488:HIV Antigens