Varicella Zoster Virus Infection in Granulomatous Arteritis of the Aorta

Varicella Zoster Virus Infection in Granulomatous Arteritis of the Aorta:

Granulomatous arteritis characterizes the pathology of giant cell arteritis (GCA), granulomatous aortitis, and intracerebral varicella zoster virus (VZV) vasculopathy. Because intracerebral VZV vasculopathy and GCA are strongly associated with productive VZV infection in cerebral and temporal arteries, respectively, we evaluated human aortas for VZV antigen and VZV DNA. Using 3 different anti-VZV antibodies, we identified VZV antigen in all of 11 aortas with pathologically verified granulomatous arteritis, in one case of non-granulomatous arteritis, and in 5/18 (28%) control aortas obtained at autopsy. The presence of VZV antigen in granulomatous aortitis was highly significant (P=0.0001) as compared to control aortas, in which VZV antigen was never associated with pathology, indicating subclinical reactivation. VZV DNA was found in most aortas containing VZV antigen. The frequent clinical, radiological and pathological aortic involvement in GCA patients correlates with the significant detection of VZV in granulomatous aortitis.

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