A novel mutation of varicella-zoster virus associated to fatal hepatitis.
BACKGROUND
Lethal varicella in immunocompetent hosts is rare and its pathogenesis is largely unknown. The discovery of glycoprotein E (gE) mutants showing attributes consistent with increased virulence in vitro and in animal models, provided a possible molecular mechanism underlying a more aggressive virus infection. However, these mutants have never been associated with unusually severe clinical cases.


OBJECTIVE
To varicella-zoster virus (VZV) mutations that correlate with increased virulence.


RESULTS
We report a case of fatal hepatitis caused by a VZV bearing a novel mutation on the 3B3 monoclonal antibody epitope of gE in an immunocompetent host.


CONCLUSIONS
This report describes a mutant VZV responsible for an aggressive clinical course in an immunocompetent host. Linking these severe clinical presentations of VZV infection to virus mutations might provide insights into the underlying pathogenic mechanisms.
Natoli
Silvia
S
Istituto di Anestesia e Rianimazione, Università di Roma Tor Vergata, Policlinico di Tor Vergata, Viale Oxford 81, 00133 Rome, Italy. silvia.natoli@ptvonline.it
Ciotti
Marco
M
Paba
Pierpaolo
P
Testore
Gian Piero
GP
Palmieri
Giampiero
G
Orlandi
Augusto
A
Sabato
Alessandro Fabrizio
AF
Leonardis
Francesca
F
D000293:Adolescent; D019943:Amino Acid Substitution; D002644:Chickenpox / Q000150:complications* / Q000821:virology*; D000939:Epitopes / Q000235:genetics / Q000276:immunology; D017809:Fatal Outcome; D006525:Hepatitis, Viral, Human / Q000821:virology*; D014645:Herpesvirus 3, Human / Q000235:genetics* / Q000472:pathogenicity; D006801:Humans; D008297:Male; D009154:Mutation; D013937:Thymidine Kinase / Q000235:genetics; D014759:Viral Envelope Proteins / Q000235:genetics / Q000276:immunology
D000939:Epitopes; D014759:Viral Envelope Proteins; C056913:glycoprotein E, varicella-zoster virus; D013937:Thymidine Kinase