Early Immune Response in Healthy and Immunocompromised Subjects with Primary Varicella-Zoster Virus Infection

• Published in: The Journal of infectious diseases Vol. 154; no. 3; pp. 422 - 429
• Main Authors: Arvin, Ann M., Koropchak, Celine M., Williams, Bryan R. G., Grumet, F. Carl, Foung, Steven K. H.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.09.1986; University of Chicago Press
• Subjects: Adolescent; Adult; Antibodies; Antibodies, Viral - analysis; Antibody Formation; Antigens; Antigens, Surface - analysis; Biological and medical sciences; Chickenpox; Chickenpox - immunology; Child; Child, Preschool; Herpesvirus 3, Human - immunology; Human viral diseases; Humans; Immune Tolerance; Immunity; Immunity, Cellular; Immunoglobulin G - immunology; Immunoglobulin M - immunology; Infections; Infectious diseases; Interferon Type I - blood; Lesions; Lymphocyte Activation; Lymphocytes; Medical sciences; Original Articles; T lymphocytes; T-Lymphocytes - immunology; varicella-zoster virus; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; Viremia; Infection; Virus; α-Herpesvirinae; Varicella zoster virus; Immunosuppression; Skin disease; Immunological investigation; Primary infection; Herpesviridae; Viral disease; Varicella
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/154.3.422

Events in pathogenesis and immunity during primary varicella-zoster virus (VZV) infection were examined in 64 healthy subjects and 21 immunocompromised patients. Activation of the interferon system and activation of circulating T lymphocytes were early immune responses that occurred during the incubation period in some healthy subjects. Elevated levels of 2-5A synthetase in peripheral blood mononuclear cells and detection of serum alpha interferon (IFN-α) and gamma interferon (IFN-y) were present in the majority of healthy subjects who had acute primary VZV infection. Expression of HLADR antigen occurred on circulating T lymphocytes from subjects with acute VZV infection. The early production of VZV-specific IgG or IgM antibodies did not correlate with the severity of the clinical infection, but the detection of T lymphocyte proliferation to VZV antigen within three days after the appearance of the varicella exanthem was associated with milder illness. The mean VZV-specific lymphocyte transformation for subjects with <100 lesions/m2 was 7.5 ± 10:43 SD compared with 1.4 ± 1.85 SD for those with >400 lesions/m2 (P < .05). Only one (7.7%) of 13 immunocompromised patients had early VZV-specific lymphocyte transformation compared with 19(42%) of 45 healthy subjects (P < .05). The rapid host response to primary VZV infection was associated with rapid termination of viremia in healthy subjects; VZV was isolated from only 11% of peripheral blood mononuclear cell samples cultured within 48 hr after the appearance of the exanthem.