Varicella zoster viraemia during herpes zoster is not associated with neoplasia.
BACKGROUND
Shingles are caused by an endogenous or exogenous reinfection with varicella zoster virus (VZV). Up to 50% of individuals with Hodgkin's disease develop herpes zoster; however, no association could be shown between the occurrence of herpes zoster and underlying subclinical malignancies.


OBJECTIVE
This study was conducted to investigate whether VZV DNA could be detected by polymerase chain reaction (PCR) in the blood of herpes zoster patients and whether there was an association between VZV viraemia and previous or concurrent neoplasias.


METHODS
At least five blood samples from 28 patients with herpes zoster were investigated by internally controlled PCR enzyme-linked immunosorbent assay prior to and during therapy with aciclovir.


RESULTS
None of 13 patients, two with a history of neoplasia and two with a neoplasia at the time of the study, showed any signs of viraemia with VZV, and 14 patients had inconsistent viraemia, one with a history of neoplasia and two with neoplasia at the time of the study. In one patient VZV DNA was detected in the blood for 6 days. This patient died soon after from metastatic malignant melanoma.


CONCLUSIONS
VZV viraemia may occur during herpes zoster episodes, even in patients without evidence of immunosuppression; however, this viraemia is, in most cases, inconsistent and does not provide any specific information concerning underlying unrecognized malignancies.
Bezold
G
G
Department of Dermatology, University of Ulm, Germany.
Lange
M
M
Pillekamp
H
H
Peter
R U
RU
D000212:Acyclovir / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D001483:Base Sequence; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006562:Herpes Zoster / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D014645:Herpesvirus 3, Human / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology*; D016133:Polymerase Chain Reaction / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D014766:Viremia / Q000175:diagnosis* / Q000453:epidemiology
D004279:DNA, Viral; D000212:Acyclovir