TY - JOUR
T1 - Corneal herpes simplex virus type 1 superinfection in patients with recrudescent herpetic keratitis
AU - Remeijer, Lies
AU - Maertzdorf, Jeroen
AU - Buitenwerf, Johannes
AU - Osterhaus, Albert D M E
AU - Verjans, Georges M G M
PY - 2002/2
Y1 - 2002/2
N2 - PURPOSE: Herpetic keratitis is a common sequel of a corneal infection with herpes simplex virus (HSV)-1. Recrudescent herpetic keratitis (RHK) may result in irreversible damage to the cornea. Recurrences may be caused by reactivation of endogenous HSV-1 or reinfection with exogenous HSV-1. The objective of this study was to determine the incidence and risk factors involved of HSV-1 superinfection in patients with RHK.METHODS: From 30 patients with RHK, sequential corneal HSV-1 isolates were genotyped by PCR amplification of the hypervariable regions located within the HSV-1 genes US1, US10/11, and US12. The clinical data from the patients obtained retrospectively were: ophthalmologic history, clinical picture during recurrences, number and time points of penetrating keratoplasty (PKP), and steroid or acyclovir treatment.RESULTS: Whereas the sequential corneal HSV-1 isolates of 19 (63%) of 30 patients had the same genotype (designated as group 1), the sequential isolates of 11 patients (37%) were genetically different (designated as group 2). Among the clinical data analyzed, only the time point of PKP was significantly different between the patient groups. Although no patients in group 1 had undergone transplantation between samplings, 4 of 11 patients in group 2 underwent PKP during the inter-recurrence period in the same eye from which the corneal HSV-1 isolates were obtained.CONCLUSIONS: The data demonstrate that RHK is frequently associated with corneal reinfection with a different HSV-1 strain and suggest that PKP is a risk factor for corneal HSV-1 superinfection.
AB - PURPOSE: Herpetic keratitis is a common sequel of a corneal infection with herpes simplex virus (HSV)-1. Recrudescent herpetic keratitis (RHK) may result in irreversible damage to the cornea. Recurrences may be caused by reactivation of endogenous HSV-1 or reinfection with exogenous HSV-1. The objective of this study was to determine the incidence and risk factors involved of HSV-1 superinfection in patients with RHK.METHODS: From 30 patients with RHK, sequential corneal HSV-1 isolates were genotyped by PCR amplification of the hypervariable regions located within the HSV-1 genes US1, US10/11, and US12. The clinical data from the patients obtained retrospectively were: ophthalmologic history, clinical picture during recurrences, number and time points of penetrating keratoplasty (PKP), and steroid or acyclovir treatment.RESULTS: Whereas the sequential corneal HSV-1 isolates of 19 (63%) of 30 patients had the same genotype (designated as group 1), the sequential isolates of 11 patients (37%) were genetically different (designated as group 2). Among the clinical data analyzed, only the time point of PKP was significantly different between the patient groups. Although no patients in group 1 had undergone transplantation between samplings, 4 of 11 patients in group 2 underwent PKP during the inter-recurrence period in the same eye from which the corneal HSV-1 isolates were obtained.CONCLUSIONS: The data demonstrate that RHK is frequently associated with corneal reinfection with a different HSV-1 strain and suggest that PKP is a risk factor for corneal HSV-1 superinfection.
KW - Acyclovir/therapeutic use
KW - Adolescent
KW - Adult
KW - Aged
KW - Antiviral Agents/therapeutic use
KW - Cornea/virology
KW - DNA, Viral/analysis
KW - Female
KW - Genotype
KW - Herpesvirus 1, Human/genetics
KW - Humans
KW - Incidence
KW - Keratitis, Herpetic/epidemiology
KW - Keratoplasty, Penetrating
KW - Male
KW - Middle Aged
KW - Polymerase Chain Reaction
KW - Recurrence
KW - Risk Factors
KW - Superinfection/epidemiology
KW - Virus Activation
M3 - Article
C2 - 11818377
SN - 0146-0404
VL - 43
SP - 358
EP - 363
JO - Investigative ophthalmology & visual science
JF - Investigative ophthalmology & visual science
IS - 2
ER -