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J Med Virol. 2019 Jul 9. doi: 10.1002/jmv.25543. [Epub ahead of print]

Relationships of varicella zoster virus (VZV)-specific cell-mediated immunity and persistence of VZV DNA in saliva and the development of postherpetic neuralgia in patients with herpes zoster.

Author information

1
Department of Infectious Diseases, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
2
Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
3
Division of Infectious Diseases, Chung-Ang University Hospital, Seoul, Republic of Korea.

Abstract

BACKGROUND:

There are no surrogate markers for the development of postherpetic neuralgia (PHN) in patients with herpes zoster (HZ).

METHODS:

All patients with HZ were prospectively enrolled to evaluate the associations of saliva varicella zoster virus (VZV) DNA persistence and VZV-specific cell-mediated immunity (CMI) with the development of PHN. Slow clearers were defined if salivary VZV DNA persisted after day 15.

RESULTS:

Salivary VZV was detected in 60 (85.7%) of a total of 70 patients with HZ on initial presentation. Of 38 patients for whom follow-up saliva samples were available, 26 (68.4%) were classified as rapid clearers, and 12 (31.6%) as slow cleares. Initial VZV-specific CMI was lower in slow clearers than rapid clearers (median 45 vs 158 spot forming cells/106 cells, P=0.02). Of the 70 patients with HZ, 22 (31.4%) eventually developed PHN. Multivariate analysis showed that slow clearers (OR 15.7, P=0.01) and lower initial VZV-specific CMI (OR 13.8, P=0.04) were independent predictors of the development of PHN, after adjustment for age and immunocompromised status.

CONCLUSIONS:

Initial low VZV CMI response and persistence of VZV DNA in saliva may be associated with the development of PHN. This article is protected by copyright. All rights reserved.

KEYWORDS:

cell mediated immunity; herpes zoster; postherpetic neuralgia; saliva; varicella-zoster virus (VZV)

PMID:
31286531
DOI:
10.1002/jmv.25543

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