Quinlivan M L, Ayres K, Ran H, McElwaine S, Leedham-Green M, Scott F T, Johnson R W, Breuer J
Centre for Infectious Disease, Institute of Cell and Molecular Science, Barts, and the London School of Medicine and Dentistry, Queen Mary College, London, UK.
J Clin Microbiol. 2007 Dec;45(12):3909-14. doi: 10.1128/JCM.00874-07. Epub 2007 Sep 12.
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.
水痘带状疱疹病毒（VZV）是疱疹病毒科的成员，初次感染该病毒会引发水痘，更常见的名称是水痘。作为α疱疹病毒亚科成员的特征，VZV具有嗜神经性，并在感觉神经元中建立潜伏状态。VZV的重新激活会导致带状疱疹，也称为蛇串疮。带状疱疹最常见的并发症是慢性且通常使人衰弱的疼痛，称为带状疱疹后神经痛（PHN），这种疼痛在皮疹消失后可能会持续数月。在急性带状疱疹发作期间，部分（但不是全部）患者会出现VZV病毒血症；然而，病毒载量对疾病结局的影响尚不清楚。在此，我们描述了一种高度特异性、灵敏且可重复的实时PCR检测方法的开发，以研究可能导致带状疱疹患者基线病毒血症的存在和水平的因素，并确定病毒血症与PHN的发生和持续之间的关系。在78%的急性带状疱疹患者的外周血单个核细胞（PBMC）中检测到了VZV DNA，在9%的健康无症状献血者中也检测到了该病毒。急性带状疱疹患者PBMC中VZV的存在与年龄和使用抗病毒药物独立相关，但与性别、免疫状态、皮疹范围、采血时皮疹的年龄、有前驱疼痛病史或急性疼痛程度无关。前驱疼痛与较高的基线病毒载量显著相关。病毒载量水平与6周、12周或26周时PHN的发生或持续无关。
