Diagnostic Usefulness of Varicella-Zoster Virus Real-Time Polymerase Chain Reaction Analysis of DNA in Saliva and Plasma Specimens From Patients With Herpes Zoster.
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.
['Park|Seong Yeon|SY|', 'Kim|Ji Yeun|JY|', 'Kim|Ji-Ae|JA|', 'Kwon|Ji-Soo|JS|', 'Kim|Sun-Mi|SM|', 'Jeon|Na Young|NY|', 'Kim|Min-Chul|MC|', 'Chong|Yong Pil|YP|', 'Lee|Sang-Oh|SO|', 'Choi|Sang-Ho|SH|', 'Kim|Yang Soo|YS|', 'Woo|Jun Hee|JH|', 'Kim|Sung-Han|SH|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D004279:DNA, Viral D005260:Female D006562:Herpes Zoster D014645:Herpesvirus 3, Human D006801:Humans D008297:Male D008875:Middle Aged D025202:Molecular Diagnostic Techniques D010949:Plasma D011446:Prospective Studies D060888:Real-Time Polymerase Chain Reaction D012463:Saliva D012680:Sensitivity and Specificity D055815:Young Adult
saliva plasma Herpes zoster varicella-zoster virus (VZV)