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Journal of Clinical Microbiology, November 2005, p. 5614-5621, Vol. 43, No. 11
0095-1137/05/$08.00+0 doi:10.1128/JCM.43.11.5614-5621.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands,1 Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands,2 Department of Medical Microbiology, Section of Virology, Academic Medical Center, Amsterdam, The Netherlands3
Received 4 August 2004/ Returned for modification 27 September 2004/ Accepted 15 August 2005
In immunocompetent children with primary varicella-zoster virus (VZV) infection, peak viral loads are detected in peripheral blood near the onset of the vesicular rash. VZV DNA concentrations normally diminish and become undetectable within 3 weeks after the appearance of the exanthem. Here, we present a previously healthy, human immunodeficiency virus-negative, 4-year-old boy admitted with severe varicella. High viral loads (>340,000 copies/ml) were found in his blood, and the viral loads remained high for at least 1.5 years. Clinical recovery preceded complete clearance of the virus. General and VZV-specific immune reactivity were intact. NK cells and CD8+ T cells were activated during acute infection, and VZV-specific CD4+ T cells were detected at high frequencies. VZV DNA was initially detected in B cells, NK cells, and both CD4+ and CD8+ T cells. In contrast, during the persistent phase of VZV DNA detection, the viral DNA was primarily located in CD8+ T cells. For the first time, we describe the persistent detection of VZV DNA in a previously healthy child.
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