Varicella Zoster Virus Insights
Dr. Maria Nagel empowers health care providers and patients with clinical and basic research information on the neurological and systemic diseases produced by varicella zoster virus that is latent in >90% of the world population and reactivates to produce disease in one-third during their lifetime.
HERPES ZOSTER (SHINGLES) • RAMSAY HUNT SYNDROME • POSTHERPETIC NEURALGIA • ZOSTER SINE HERPETE ("INTERNAL SHINGLES") • VZV VASCULOPATHY • COGNITIVE IMPAIRMENT • BURNING MOUTH SYNDROME • MULTISYSTEM DISEASE • MULTISYSTEM DISEASE • VIRAL PATHOGENESIS
Herpesviruses
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Varicella zoster virus (VZV) is one of 9 human herpesviruses (HHVs). HHVs are double-stranded, DNA viruses characterized by their ability to infect a human host on primary infection (with or without clinical disease) after which virus establishes lifelong latency in specific cells in the body. During latency, no infectious virions or diseases are produced and the virus effectively evades immune clearance for decades. With a weakened immune system, virus can reactivate, produce infectious virus particles, spread to various parts of the body, and cause corresponding disease. Virus can also "subclinically reactivate" wherein viral DNA is detected but no overt clinical disease is seen. Below are just some (but not all) of the diseases these HHVs produce. As awareness of these common viruses increase, we continue to learn other manifestations associated with reactivation
HHV Type
Virus Name
Primary Disease / Notes
HHV-1
Herpes simplex type 1
Herpes labialis (cold sores), encephalitis, keratitis
HHV-2
Herpes simplex type 2
Genital herpes, encephalitis, meningitis
HHV-3
Varicella zoster virus
Varicella (chickenpox), herpes zoster (shingles), postherpetic neuralgia, stroke
HHV-4
Epstein-Barr virus
Mononucleosis, chronic fatigue, various lymphomas
HHV-5
Cytomegalovirus
Congenital infection, retinitis, mono-like syndrome
HHV-6A/B
HHV-6
HHV-6A, neuroinflammatory/neurodegenerative condition; HHV-6B, Roseola infantum (sixth disease)
HHV-7
HHV-7
Roseola infantum
HHV-8
KSHV
Kaposi's sarcoma, primary effusion lymphoma, Castleman's disease
Dr. Maria Nagel
Dr. Nagel is a Professor and Cockerill-Wittmus Endowed Chair in Neurology at the University of Colorado Anschutz School of Medicine in Aurora, CO, USA. She is the world expert on neurological and systemic manifestations of varicella zoster virus (VZV) including:
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Herpes zoster (shingles)
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Ramsay Hunt syndrome
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Zoster sine herpete (shingles without rash, internal shingles)
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Postherpetic neuralgia
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VZV vasculopathy (ischemic/hemorrhagic stroke, aneurysm, blood clots)
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Dr. Nagel's mission is to provide health care providers and patients with knowledge on how to tackle this common, yet under-recognized virus and to inspire the next generation of VZV-focused clinicians and researchers.
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