Prevalence and clinical consequences of herpes simplex virus type 1 DNA in human cornea tissues.
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.
Remeijer
Lies
L
Rotterdam Eye Hospital, Rotterdam, The Netherlands.
Duan
Rui
R
van Dun
Jessica M
JM
Wefers Bettink
Mark A
MA
Osterhaus
Albert D M E
AD
Verjans
Georges M G M
GM
D015331:Cohort Studies; D003315:Cornea / Q000601:surgery / Q000821:virology*; D003316:Corneal Diseases / Q000601:surgery / Q000821:virology; D016039:Corneal Transplantation / Q000379:methods; D004279:DNA, Viral / Q000235:genetics*; D006085:Graft Survival; D006562:Herpes Zoster / Q000601:surgery / Q000821:virology; D018259:Herpesvirus 1, Human / Q000235:genetics*; D018258:Herpesvirus 2, Human / Q000235:genetics; D014645:Herpesvirus 3, Human / Q000235:genetics; D006801:Humans; D015948:Keratoplasty, Penetrating; D012189:Retrospective Studies; D017211:Treatment Failure
D004279:DNA, Viral