Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Feb 3;66(2):4.
doi: 10.1167/iovs.66.2.4.

Prevalence of HSV Genomic Signatures Among Acanthamoeba Hosts and Contaminated Lens Cases: A Molecular and Clinical Study

Juan-Carlos Navia  1   2   3 , Alexander Alfonso  2 , Darlene Miller  2   3 , Jorge Maestre-Mesa  2 , Heather Durkee  1 , Paula A Sepulveda-Beltran  3 , Felipe Echeverri-Tribin  1 , Salomon Merikansky  2   3 , Jaime D Martinez  3 , Harry W Flynn Jr  2   3 , Eduardo C Alfonso  3 , Jean-Marie Parel  1   3 , Guillermo Amescua  1   2   3
Affiliations

Prevalence of HSV Genomic Signatures Among Acanthamoeba Hosts and Contaminated Lens Cases: A Molecular and Clinical Study

Juan-Carlos Navia et al. Invest Ophthalmol Vis Sci. .

Abstract

Purpose: 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.

Methods: 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.

Results: 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%.

Conclusions: 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.

PubMed Disclaimer

Conflict of interest statement

Disclosure: J.-C. Navia, None; A. Alfonso, None; D. Miller, None; J. Maestre-Mesa, None; H. Durkee, None; P.A. Sepulveda-Beltran, None; F. Echeverri-Tribin, None; S. Merikansky, None; J.D. Martinez, None; H.W. Flynn, None; E.C. Alfonso, None; J.-M. Parel, None; G. Amescua, None

Figures

Figure 1.
Figure 1.
Schematic of methodology. Created in BioRender. Navia, J. (2025).
Figure 2.
Figure 2.
Cropped agarose gel image of PCR amplicons of Acanthamoeba isolates. Bands were visualized using 1% gel electrophoresis. JDP forward/reverse yielded 450-bp amplicons. A. castellanii (ATCC 30010) was used as positive control and sterile water as negative control. Created in BioRender. Navia, J. (2025).
Figure 3.
Figure 3.
Cropped agarose gel image of PCR amplicons of HSV from Acanthamoeba isolates using HSV primers for both HSV type 1 and 2. Primers HSV1-2 forward and HSV1-2 reverse yielded 179-bp amplicons. Bands were visualized using 1% gel electrophoresis. Positives controls for HSV were obtained from verified laboratory samples and sterile water was used as negative control. Created in BioRender. Navia, J. (2025).
Figure 4.
Figure 4.
(A) Agarose gel image of PCR amplicons of HSV type 1 from Acanthamoeba isolates. Bands were visualized using 1% gel electrophoresis; primer pairs HSVn7 and HSV n8C yielded 350-bp amplicons. (B) Agarose gel image of PCR amplicons of HSV type 2 from Acanthamoeba isolates. Bands were visualized using 1% gel electrophoresis; primer pairs HSV2 forward and HSV2 reverse yielded 120-bp amplicons. Positive controls were obtained from verified laboratory samples and sterile water was used as negative control. Created in BioRender. Navia, J. (2025).
Figure 5.
Figure 5.
Best-corrected visual acuity in patients with AK without HSV signatures (green) and with HSV signatures (blue).
Figure 6.
Figure 6.
Herpesviridae genomic signatures distribution among contaminated CL cases.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Bagga B, Joseph J, Garg P, et al. .. Efficacy of topical miltefosine in patients with Acanthamoeba keratitis: a pilot study. Ophthalmology. 2018; 126(5): 768–770. - PubMed
    1. Lorenzo-Morales J, Martín-Navarro CM, López-Arencibia A, Arnalich-Montiel F, Piñero JE, Valladares B. Acanthamoeba keratitis: an emerging disease gathering importance worldwide? Trends Parasitol. 2013; 29(4): 181–187. - PubMed
    1. Alreshidi SO, Vargas JM, Ahmad K, et al. .. Differentiation of Acanthamoeba keratitis from other non- Acanthamoeba keratitis: risk factors and clinical features. Lalgudi VG, ed. PLoS One. 2024; 19(3): e0299492. - PMC - PubMed
    1. Hammersmith KM. Diagnosis and management of Acanthamoeba keratitis. Curr Opin Ophthalmol. 2006; 17(4): 327–331. - PubMed
    1. Zhang Y, Xu X, Wei Z, Cao K, Zhang Z, Liang Q.. The global epidemiology and clinical diagnosis of Acanthamoeba keratitis. J Infect Public Health. 2023; 16(6): 841–852. - PubMed

MeSH terms