Navia Juan-Carlos, Alfonso Alexander, Miller Darlene, Maestre-Mesa Jorge, Durkee Heather, Sepulveda-Beltran Paula A, Echeverri-Tribin Felipe, Merikansky Salomon, Martinez Jaime D, Flynn Harry W, Alfonso Eduardo C, Parel Jean-Marie, Amescua Guillermo
Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States.
Ocular Microbiology Laboratory, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States.
Invest Ophthalmol Vis Sci. 2025 Feb 3;66(2):4. doi: 10.1167/iovs.66.2.4.
To document the presence of herpes simplex virus (HSV) genomic signatures among Acanthamoeba hosts recovered from patients with Acanthamoeba keratitis (AK) and in contaminated lens cases.
We used a combination of PCR sequencing and shotgun metagenomics to detect and confirm the presence of HSV genomic signatures in Acanthamoeba hosts and lens cases. Clinical outcomes were correlated with the prevalence of host HSV signatures.
HSV genomic signatures were detected in 26% (n = 6) of Acanthamoeba hosts recovered from patients with culture confirmed AK. HSV-1 and HSV-2 or both were identified in 33%, 50%, and 17% of isolates, respectively. Fifty-two percent of patients (12/23) were misdiagnosed initially as presenting with HSV keratitis. Patients with HSV-positive Acanthamoeba isolates had a mean best-corrected visual acuity of 1.43 LogMAR at diagnosis and 0.53 LogMAR at follow-up, compared with 1.85 and 0.92 LogMAR, respectively, in HSV-negative cases. Contact lens use was identified as a risk factor in 83% of 18 patients. We detected 46,597 viral signatures in 5 of 14 contaminated lens cases (35.7%). Distribution included 33% bacteriophages, 8.2% giant viruses, 4.1% nonhuman Herpesviridae, and 0.39% human Herpesviridae. Among the 184 human Herpesviridae genomic signatures, HSV types 1 or 2 or both were documented in 5.7%, VZV in 39.7%, HHV7 in 38.6%, HHV6 in 15.0%, and Epstein-Barr virus in 0.5%.
This study is the first to identify HSV-positive genomic signatures in clinical AK isolates and/or contact lens cases. Taken together, the high prevalence of HSV genomic signatures in both amebic hosts and lens cases, might signal an unrecognized Acanthamoeba-HSV association and the need for reassessing current management.
记录从棘阿米巴角膜炎（AK）患者体内分离出的棘阿米巴宿主以及受污染镜片样本中单纯疱疹病毒（HSV）基因组特征的存在情况。
我们联合使用聚合酶链反应测序和鸟枪法宏基因组学技术，以检测并确认HSV基因组特征在棘阿米巴宿主和镜片样本中的存在情况。将临床结果与宿主HSV特征的流行率进行关联分析。
在经培养确诊为AK的患者所分离出的棘阿米巴宿主中，26%（n = 6）检测到HSV基因组特征。在分离株中，分别有33%、50%和17%鉴定出HSV-1、HSV-2或两者皆有。52%的患者（12/23）最初被误诊为患有HSV角膜炎。HSV阳性棘阿米巴分离株的患者在诊断时平均最佳矫正视力为1.43 LogMAR，随访时为0.53 LogMAR，而HSV阴性病例分别为1.85和0.92 LogMAR。在18例患者中，83%的患者将佩戴隐形眼镜确定为危险因素。在14份受污染镜片样本中的5份（35.7%）检测到46,597个病毒特征。分布情况包括33%的噬菌体、8.2%的巨型病毒、4.1%的非人类疱疹病毒科病毒以及0.39%的人类疱疹病毒科病毒。在184个人类疱疹病毒科基因组特征中，HSV 1型或2型或两者皆有的记录占5.7%，水痘带状疱疹病毒（VZV）占39.7%，人疱疹病毒7型（HHV7）占38.6%，人疱疹病毒6型（HHV6）占15.0%，爱泼斯坦-巴尔病毒占0.5%。
本研究首次在临床AK分离株和/或隐形眼镜样本中鉴定出HSV阳性基因组特征。综合来看，HSV基因组特征在阿米巴宿主和镜片样本中的高流行率，可能表明存在未被认识的棘阿米巴与HSV的关联，以及重新评估当前治疗方法的必要性。
