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Related Experiment Video

Updated: Mar 7, 2026

Porcine Corneal Tissue Explant to Study the Efficacy of Herpes Simplex Virus-1 Antivirals

Porcine Corneal Tissue Explant to Study the Efficacy of Herpes Simplex Virus-1 Antivirals

Published on: September 20, 2021

Treatment failure in herpes simplex virus type 1 keratitis.

Anna C Randag¹, Georges Mgm Verjans², Lies Remeijer³

¹Cornea and External Diseases Department, Rotterdam Eye Hospital, Rotterdam, The Netherlands a.randag@oogziekenhuis.nl.

The British Journal of Ophthalmology

|March 5, 2026

Summary

Aciclovir-resistant herpes simplex virus type 1 (HSV-1) keratitis is rare but challenging. This review explores HSV-1 keratitis pathogenesis, treatment failure causes, and options for resistant cases.

Keywords:

Cornea Infection Inflammation Pharmacology Treatment Medical

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Ex Vivo Organotypic Corneal Model of Acute Epithelial Herpes Simplex Virus Type I Infection

Ex Vivo Organotypic Corneal Model of Acute Epithelial Herpes Simplex Virus Type I Infection

Published on: November 3, 2012

Area of Science:

Ophthalmology
Virology
Infectious Diseases

Background:

Herpes simplex virus type 1 (HSV-1) commonly causes recurrent ocular infections (keratitis).
Current treatments involve nucleoside analogues like aciclovir (ACV), often with corticosteroids.
Treatment failure can stem from adherence issues, incorrect dosing, misdiagnosis, coinfections, or drug resistance.

Purpose of the Study:

To review the pathogenesis of HSV-1 keratitis.
To define and explore causes of treatment failure in HSV-1 keratitis.
To discuss the development and management of aciclovir-resistant (ACV^R) HSV-1 keratitis.

Main Methods:

Literature review of HSV-1 keratitis pathogenesis and treatment.
Analysis of factors contributing to treatment failure.
Examination of ACV resistance mechanisms and treatment strategies.

Main Results:

Aciclovir resistance (ACV^R) occurs in approximately 6% of immunocompetent patients with HSV-1 keratitis.
ACV resistance compromises the effectiveness of standard antiviral therapies.
Identifying causes of treatment failure is crucial for effective management.

Conclusions:

Understanding HSV-1 keratitis pathogenesis is key to managing treatment failures.
A systematic work-up is necessary for refractory cases.
Novel treatment strategies are needed for ACV^R HSV-1 keratitis to prevent disease progression.