title: Persistent detection of varicella-zoster virus DNA in a previously healthy child after severe chickenpox.
abstract: 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.
authors.affiliation: Academic Medical Center, Emma Children's Hospital, Room G8-205, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Mireille T M
authors.initials: MT
authors.lastname: Vossen
authors.forename: Mi-Ran
authors.initials: MR
authors.lastname: Gent
authors.forename: Karla M C
authors.initials: KM
authors.lastname: Peters
authors.forename: Pauline M E
authors.initials: PM
authors.lastname: Wertheim-van Dillen
authors.forename: Koert M
authors.initials: KM
authors.lastname: Dolman
authors.forename: Alex
authors.initials: A
authors.lastname: van Breda
authors.forename: René A W
authors.initials: RA
authors.lastname: van Lier
authors.forename: Taco W
authors.initials: TW
authors.lastname: Kuijpers
mesh_terms: D001402:B-Lymphocytes / Q000821:virology; D015496:CD4-Positive T-Lymphocytes / Q000821:virology; D018414:CD8-Positive T-Lymphocytes / Q000821:virology; D002644:Chickenpox / Q000276:immunology / Q000821:virology*; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood; D014645:Herpesvirus 3, Human / Q000235:genetics; D006801:Humans; D007121:Immunocompetence; D007694:Killer Cells, Natural / Q000821:virology; D008297:Male; D019562:Viral Load
chemical_list: D004279:DNA, Viral