Diagnostic Usefulness of Varicella-Zoster Virus Real-Time Polymerase Chain Reaction Analysis of DNA in Saliva and Plasma Specimens From Patients With Herpes Zoster

• Published in: The Journal of infectious diseases Vol. 217; no. 1; pp. 51 - 57
• Main Authors: Park, Seong Yeon, Kim, Ji Yeun, Kim, Ji-Ae, Kwon, Ji-Soo, Kim, Sun-Mi, Jeon, Na Young, Kim, Min-Chul, Chong, Yong Pil, Lee, Sang-Oh, Choi, Sang-Ho, Kim, Yang Soo, Woo, Jun Hee, Kim, Sung-Han
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01.01.2018
• Subjects: Adult; Aged; Aged, 80 and over; DNA, Viral - genetics; DNA, Viral - isolation & purification; Female; Herpes Zoster - diagnosis; Herpesvirus 3, Human - genetics; Herpesvirus 3, Human - isolation & purification; Humans; Male; Middle Aged; Molecular Diagnostic Techniques - methods; Plasma - virology; Prospective Studies; Real-Time Polymerase Chain Reaction - methods; Saliva - virology; Sensitivity and Specificity; Young Adult; saliva; Herpes zoster; plasma; varicella-zoster virus (VZV)
• ISSN: 0022-1899; 1537-6613; 1537-6613
• DOI: 10.1093/infdis/jix508

The sensitivity of polymerase chain reaction analysis of salivary DNA for detecting varicella-zoster virus (88%) was higher than that of plasma (28%) among 82 patients with suspected herpes zoster (ie, 52 with a diagnosis of herpes zoster and 30 with a diagnosis of zoster-mimicking disease). Abstract Background We evaluated the diagnostic usefulness of polymerase chain reaction (PCR) analysis for detecting varicella-zoster virus (VZV) infection and reactivation of VZV, using DNA extracted from saliva and plasma specimens obtained from subjects with suspected herpes zoster and from healthy volunteers during stressful and nonstressful conditions. Methods There were 52 patients with a diagnosis of herpes zoster (group 1), 30 with a diagnosis of zoster-mimicking disease (group 2), and 27 healthy volunteers (group 3). Saliva and plasma samples were evaluated for VZV DNA by real-time PCR analysis. Results Among patients with suspected herpes zoster (ie, patients in groups 1 and 2), the sensitivity of PCR analysis of salivary DNA for detecting VZV (88%; 95% confidence interval [CI], 74%–95%) was significantly higher than that of PCR analysis of plasma DNA (28%; 95% CI, 16%–44%; P < .001), whereas the specificity of PCR analysis of salivary DNA (100%; 95% CI, 88%–100%) was similar to that of PCR analysis of plasma DNA (100%; 95% CI, 78%–100%; P > .99). VZV DNA was not detected in saliva and plasma samples from group 3 (0%; 95% CI, 0%–14%). Conclusions Real-time PCR analysis of salivary DNA is more sensitive than that of plasma DNA for detecting VZV among patients with suspected herpes zoster. We found no subclinical reactivation of VZV in group 3 following exposure to common stressful conditions.