Herpes Zoster and Giant Cell Arteritis Save

The potential association of herpes zoster with giant cell arteritis (GCA) has been a debated topic and certainly has gotten some attention at ACR 2016 this year.

Muratore, et al. presented an abstract at today’s poster session (#2075) that I thought was quite notable. Given that several previous studies have looked for (and some found) VZV infection within temporal arteries of GCA patients, this group sough to analyze TAs from biopsy-positive GCA patients, biopsy-negative GCA patients and controls, looking for VZV infection.

They had 79 formalin-fixed, paraffin-embedded (FFPE) temporal artery biopsies from 34 biopsy-positive GCA patients, 15 biopsy-negative GCA patients and 30 controls. They were analyzed by immunohistochemistry using a mouse monoclonal anti-VZV glycoprotein antibody. DNA was also extracted and examined with PCR looking for VZV DNA. Frozen sections were also analyzed. An FFPE skin biopsy from a patient with VZV infection was used as a positive control.

Interestingly, immunohistochemical analysis detected VZV antigen in only 1 of the 34 biopsy-proven GCA samples, and none of the biopsy-negative samples or controls. VZV DNA was also not detected in any of the samples. Their findings do not support a role for VZV infection in GCA, and this does differ from previous studies (https://www.ncbi.nlm.nih.gov/pubmed/26349037, https://www.ncbi.nlm.nih.gov/pubmed/25695965 ). T

his topic remains a grey area and this abstract is an interesting addition to the growing literature.