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

J Infect Dis. 2009 Jul 1;200(1):11-9. doi: 10.1086/599329.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cohort Studies
  • Cornea / surgery
  • Cornea / virology*
  • Corneal Diseases / surgery
  • Corneal Diseases / virology
  • Corneal Transplantation / methods
  • DNA, Viral / genetics*
  • Graft Survival
  • Herpes Zoster / surgery
  • Herpes Zoster / virology
  • Herpesvirus 1, Human / genetics*
  • Herpesvirus 2, Human / genetics
  • Herpesvirus 3, Human / genetics
  • Humans
  • Keratoplasty, Penetrating
  • Retrospective Studies
  • Treatment Failure


  • DNA, Viral