Blinded search for varicella zoster virus in giant cell arteritis (GCA)-positive and GCA-negative temporal arteries

• Published in: Journal of the Neurological Sciences
• Main Authors: Gilden, Don, White, Teresa, Khmeleva, Nelly, Katz, Bradley J., Nagel, Maria A.
• Format: Text
• Language: English
• Published: 2016
• Subjects: Article; Canada; Iceland
• Online Access: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834150/; http://www.ncbi.nlm.nih.gov/pubmed/27084233; https://doi.org/10.1016/j.jns.2016.03.020

Recent analysis of archived temporal arteries (TAs) acquired from 13 pathology laboratories in the US, Canada, Iceland, France, Germany and Israel from patients with pathologically-verified giant cell arteritis (GCA-positive) and TAs from patients with clinical features and laboratory abnormalities of GCA but whose TAs were pathologically negative (GCA-negative) revealed VZV antigen in most TAs from both groups. Despite formalin-fixation, VZV DNA was also found in many VZV-antigen positive sections that were scraped, subjected to DNA extraction, and examined by PCR with VZV-specific primers. Importantly, in past studies, the pathological diagnosis (GCA-positive or -negative) was known to the neurovirology laboratory. Herein, GCA-positive and GCA-negative TAs were provided by an outside institution and examined by 4 investigators blinded to the pathological diagnoses. VZV antigen was found in 3/3 GCA-positive TAs and in 4/6 GCA-negative TAs, and VZV DNA in 1/3 VZV antigen-positive, GCA-positive TAs and in 3/4 VZV antigen-positive, GCA-negative TAs. VZV DNA was also detected in one GCA-negative, VZV-antigen negative TA. Overall, the detection of VZV antigen in 78% of GCA-positive and GCA-negative TAs is consistent with previous reports on the prevalence of VZV antigen in patients with clinically suspect GCA.