This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Quinlivan, M. L.
Right arrow Articles by Breuer, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Quinlivan, M. L.
Right arrow Articles by Breuer, J.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, December 2007, p. 3909-3914, Vol. 45, No. 12
0095-1137/07/$08.00+0     doi:10.1128/JCM.00874-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Effect of Viral Load on the Outcome of Herpes Zoster{triangledown}

M. L. Quinlivan,1 K. Ayres,2 H. Ran,1 S. McElwaine,3 M. Leedham-Green,1 F. T. Scott,1 R. W. Johnson,4 and J. Breuer1*

Centre for Infectious Disease, Institute of Cell and Molecular Science, Barts, and the London School of Medicine and Dentistry, Queen Mary College, 4 Newark St., London E1 2AT, England, United Kingdom,1 Section of Applied Statistics, School of Biological Sciences, University of Reading, P.O. Box 240, Earley Gate, Reading RG6 6FN, England, United Kingdom,2 Centre for Haematology, Institute of Cell and Molecular Science, Barts, and the London School of Medicine and Dentistry, Queen Mary College, 4 Newark St., London E1 2AT, England, United Kingdom,3 Pain Management Clinic, Level 4, Bristol Royal Infirmary, Bristol BS2 8HW, England, United Kingdom4

Received 26 April 2007/ Returned for modification 23 June 2007/ Accepted 4 September 2007

Varicella-zoster virus (VZV) is a member of the Herpesviridae family, primary infection with which causes varicella, more commonly known as chicken pox. Characteristic of members of the alphaherpesvirus subfamily, VZV is neurotropic and establishes latency in sensory neurons. Reactivation of VZV causes herpes zoster, also known as shingles. The most frequent complication following zoster is chronic and often debilitating pain called postherpetic neuralgia (PHN), which can last for months after the disappearance of a rash. During episodes of acute zoster, VZV viremia occurs in some, but not all, patients; however, the effect of the viral load on the disease outcome is not known. Here we describe the development of a highly specific, sensitive, and reproducible real-time PCR assay to investigate the factors that may contribute to the presence and levels of baseline viremia in patients with zoster and to determine the relationship between viremia and the development and persistence of PHN. VZV DNA was detected in the peripheral blood mononuclear cells (PBMCs) of 78% of patients with acute zoster and in 9% of healthy asymptomatic blood donors. The presence of VZV in the PBMCs of patients with acute zoster was independently associated with age and being on antivirals but not with gender, immune status, extent of rash, the age of the rash at the time of blood sampling, having a history of prodromal pain, or the extent of acute pain. Prodromal pain was significantly associated with higher baseline viral loads. Viral load levels were not associated with the development or persistence of PHN at 6, 12, or 26 weeks.

* Corresponding author. Mailing address: Skin Virus Laboratory, Centre for Infectious Disease, Institute of Cell and Molecular Science, Barts, and the London School of Medicine and Dentistry, Queen Mary College, 4 Newark St., London E1 2AT, England, United Kingdom. Phone: 44 207 882 2308. Fax: 44 207 882 2181. E-mail: j.breuer{at}qmul.ac.uk

{triangledown} Published ahead of print on 12 September 2007.

Journal of Clinical Microbiology, December 2007, p. 3909-3914, Vol. 45, No. 12
0095-1137/07/$08.00+0     doi:10.1128/JCM.00874-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.





Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»