Subclinical Reactivation of Varicella-Zoster Virus in Immunocompromised and Immunocompetent Individuals

Abstract

The occurrence of subclinical reactivation of varicella-zoster virus (VZV) in peripheral blood mononuclear cells (PBMC) from immunocompetent subjects >60 years old without any signs of VZV-caused illnesses, and from immunocompromised patients was investigated. Altogether, 223 samples were tested by nested ORF 63 PCR assay. In addition, all positive samples were tested by ORF 14, ORF 29 and ORF 63 PCR assays, as well as by ORF 63 and ORF 68 nucleic acid sequence-based amplification assays. In 5 samples, VZV-specific DNA, but no transcripts, could be detected. Three of them belonged to the group of >60-year-olds, 1 was HIV positive, the other was being treated with chemotherapy. The results confirm the observation of other authors that subclinical reactivation occurs in both immunocompromised and healthy individuals. The failure to detect DNA in samples taken from 2 individuals several weeks later excludes a long-lasting infection of VZV in PBMC.

Stress‐induced subclinical reactivation of varicella zoster virus in astronauts

“…Because we were unable to obtain a second serum specimen from astronauts weeks to months after space flight, it was not possible to demonstrate a significant change in antibody to VZV. For example, a four-fold rise and fall in antibody to VZV has been used as evidence of subclinical VZV reactivation in both immunocompromised and immunocompetent individuals (Arvin et aL , 1983;Gershon et aL , 1984;Schunemann et aL , 1998). However, the combination of VZV DNA in saliva and a higher specific antibody response in serum of the astronauts compared to control subjects further confirms subclinical reactivation of VZV.…”

Atypical recurrent varicella in 4 patients with hemopathies

“…Transient subclinical VZV viremia has been demonstrated in peripheral blood mononuclear cells of patients with herpes zoster, and in patients who are VZV seropositive (IgMϪ, IgGϩ) with no sign of VZV-related disease. [26][27][28] In the latter patients, the viremic episodes remain probably subclinical as the patients are VZVseropositive and because of the paucity of viral load compared with that observed during varicella. 27,28 On the other hand, previous vascular injury may create a predilective site for VZV replication, leading to varicella on photodamaged sites, 29 or on other diverse skin injuries.…”

“…[26][27][28] In the latter patients, the viremic episodes remain probably subclinical as the patients are VZVseropositive and because of the paucity of viral load compared with that observed during varicella. 27,28 On the other hand, previous vascular injury may create a predilective site for VZV replication, leading to varicella on photodamaged sites, 29 or on other diverse skin injuries. 30,31 Hence, in our patients, the chemotherapy could have damaged the endothelial cells, creating predilective sites for viral attachment and replication.…”

IE63-specific T-cell responses associate with control of subclinical varicella zoster virus reactivation in individuals with malignancies

“…Herpes zoster is more common in patients with malignancies (Schmader, 2001;Sorensen et al, 2004) and may lead to severe disease with multi-dermatomal involvement and visceral dissemination, which can be lethal (Gallagher and Merigan, 1979;Onunu and Uhunmwangho, 2004;Hackanson et al, 2005;Graue et al, 2006). However, apart from clinically apparent VZV reactivation, subclinical reactivation has also been reported in both immunocompetent and immunosuppressed individuals (Schunemann et al, 1998;Quinlivan et al, 2007). Although the mechanisms underlying such reactivation are unclear, it is thought that cell-mediated immune responses are vital in controlling VZV replication (Malavige et al, , 2008b.…”