Varicella Zoster Virus and Large Vessel Vasculitis, the Absence of an Association

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Gary W. Procop
Charis Eng
Alison Clifford
Alexandra Villa-Forte
Leonard H. Calabrese
Eric Roselli
Lars Svensson
Douglas Johnston
Gosta Pettersson
Edward Soltesz
Lisa Lystad
Julian D. Perry
Alexander Blandford
Deborah A. Wilson
Gary S. Hoffman


Objective: It is controversial whether microorganisms play a role in the pathogenesis of large and medium vessel vasculitides (eg, giant cell arteritis [GCA], Takayasu arteritis [TAK] and focal idiopathic aortitis [FIA]). Recent studies have reported the presence of Varicella Zoster Virus (VZV) within formalin-fixed, paraffin-embedded temporal arteries and aortas of about three-quarters or more of patients with these conditions, and in a minority of controls. In a prospective study, we sought to confirm these findings using DNA extracted from vessels that were harvested under surgically aseptic conditions and snap frozen.

Methods and Results: DNA samples extracted from 11 surgically sterile temporal arteries and 31 surgically sterile thoracic aortas were used in an attempt to identify the vessel-associated VZV genome. Two different validated PCR methods were used. Thirty-one thoracic aorta aneurysm specimens included biopsies from 8 patients with GCA, 2 from patients with TAK, 6 from patients with FIA, and 15 from patients without vasculitis, who had non-inflammatory aneurysms. Eleven temporal artery biopsies were collected from 5 patients with GCA and 6 controls. The presence of VZV was not identified in either the specimens from patients with large vessel vasculitis or from the controls.

Conclusions: Using surgically sterile snap-frozen specimens, we were unable to confirm recent reports of the presence of VZV in either aortas or temporal arteries from patients with large vessel vasculitis or controls.

Keywords: Aorta and temporal artery biopsies, Varicella Zoster Virus, Large Vessel Vasculitis


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Procop GW, Eng C, Clifford A, Villa-Forte A, Calabrese LH, Roselli E, et al. Varicella Zoster Virus and Large Vessel Vasculitis, the Absence of an Association. PAI [Internet]. 2017 Jun. 6 [cited 2023 Sep. 30];2(2):228-3. Available from:
Author Biography

Gary S. Hoffman, Center for Vasculitis Care and Research, Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, Ohio

Gary S. Hoffman MD, MS, MACR

Professor Emeritus

Cleveland Clinic Lerner College of Medicine

Center for Vasculitis Care and Research

Department of Rheumatic and Immunologic Diseases

Cleveland, Ohio




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