Varicella zoster virus

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Varicella zoster virus

Micrograph of VZV.
Virus classification
Group: Group I (dsDNA)
Family: Herpesviridae
Subfamily: Alphaherpesvirinae
Genus: Varicellovirus
Species
• Human herpesvirus 3 (HHV-3)

Varicella zoster virus (VZV) is one of eight herpes viruses known to infect humans (and other
vertebrates). It commonly causes chicken-pox in children and both shingles and postherpetic
neuralgia in adults and rarely in children.

Nomenclature

Varicella-zoster virus is known by many names, including: chickenpox virus, varicella virus,
zoster virus, and human herpes virus type 3 (HHV-3).
[edit] Human disease

Primary VZV infection results in chickenpox (varicella), which may rarely result in
complications including encephalitis or pneumonia. Even when clinical symptoms of chickenpox
have resolved, VZV remains dormant in the nervous system of the infected person (virus
latency), in the trigeminal and dorsal root ganglia.[1] In about 10-20% of cases, VZV reactivates
later in life producing a disease known as herpes zoster or shingles. Serious complications of
shingles include postherpetic neuralgia, zoster multiplex, myelitis, herpes ophthalmicus, or zoster
sine herpete.

[edit] Morphology

VZV is closely related to the herpes simplex viruses (HSV), sharing much genome homology.
The known envelope glycoproteins (gB, gC, gE, gH, gI, gK, gL) correspond with those in HSV,
however there is no equivalent of HSV gD. VZV also fails to produce the LAT (latency-
associated transcripts) that play an important role in establishing HSV latency (herpes simplex
virus). VZV virons are spherical and 150-200 nm in diameter. Their lipid envelope encloses the
nucleocapsid of 162 capsomeres arranged in an icosahedral form.[2] Its DNA is a single, linear,
double-stranded molecule, 125,000 nt long. The capsid is surrounded by a number of loosely
associated proteins known collectively as the tegument; many of these proteins play critical roles
in initiating the process of virus reproduction in the infected cell. The tegument is in turn covered
by a lipid envelope studded with glycoproteins that are displayed on the exterior of the virion.

[edit] Treatment

The virus is very susceptible to disinfectants, notably sodium hypochlorite. Within the human
body it can be treated by a number of drugs and therapeutic agents including acyclovir for the
chicken pox, famciclovir, valaciclovir for the shingles, zoster-immune globulin (ZIG), and
vidarabine.

[edit] Vaccination

A live attenuated VZV Oka/Merck strain vaccine is available and is marketed in the United
States under the trade name Varivax. It was developed by Merck, Sharp & Dohme in the 1980s
from the Oka strain virus isolated and attenuated by Michiaki Takahashi and colleagues in the
1970s. It was submitted to the U.S. Food and Drug Administration for approval in 1990 and was
approved in 1995. Since then, it has been added to the recommended vaccination schedules for
children in Australia, the United States, and many other countries. Varicella vaccination has
raised concerns in some that the immunity induced by the vaccine may not be lifelong, possibly
leaving adults vulnerable to more severe disease as the immunity from their childhood
immunization wanes. Vaccine coverage in the United States in the population recommended for
vaccination is approaching 90%, with concomitant reductions in the incidence of varicella cases
and hospitalizations and deaths due to VZV. So far, clinical data has proved that the vaccine is
effective for over 10 years in preventing varicella infection in healthy individuals and when
breakthrough infections do occur, illness is typically mild.[2]. In 2007, the ACIP recommended a
second dose of vaccine before school entry to ensure the maintenance of high levels of varicella
immunity.[3]

In 2006, the United States Food and Drug Administration approved Zostavax for the prevention
of shingles. Zostavax is a more concentrated formulation of the Varivax vaccine, designed to
elicit an immune response in older adults whose immunity to VZV wanes with advancing age.[4]