Varicella Zoster Virus Infection in Granulomatous Arteritis of the Aorta

J Infect Dis. 2016 Jun 15;213(12):1866-71. doi: 10.1093/infdis/jiw101. Epub 2016 Mar 31.


Granulomatous arteritis characterizes the pathology of giant cell arteritis, granulomatous aortitis, and intracerebral varicella zoster virus (VZV) vasculopathy. Because intracerebral VZV vasculopathy and giant cell arteritis 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 11 of 11 aortas with pathologically verified granulomatous arteritis, in 1 of 1 cases of nongranulomatous arteritis, and in 5 of 18 control aortas (28%) obtained at autopsy. The presence of VZV antigen in granulomatous aortitis was highly significant (P = .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 patients with giant cell arteritis correlates with the significant detection of VZV in granulomatous aortitis.

Keywords: VZV; granulomatous aortitis; granulomatous arteritis.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Antibodies, Viral
  • Antigens, Viral / analysis
  • Antigens, Viral / immunology
  • Aorta / pathology*
  • Chickenpox
  • Herpes Zoster / epidemiology*
  • Herpesvirus 3, Human / immunology*
  • Humans
  • Immunohistochemistry
  • Temporal Arteries / pathology
  • Vasculitis, Central Nervous System / epidemiology*
  • Vasculitis, Central Nervous System / virology


  • Antibodies, Viral
  • Antigens, Viral