Journal List > Infect Chemother > v.42(3) > 1035002

Choi, Kim, and Oh: Genotype of Varicella Zoster Virus Isolated from Korean Elderly Patients with Herpes Zoster

Abstract

Background

Herpes zoster develops via reactivation of the latent varicella zoster virus (VZV) in neuronal ganglia as host immunity declines. In Korea, seroprevalence of VZV is very high and population at risk for herpes zoster is increasing. The goal of this study is to evaluate the infection rate of the VZV and the lifetime prevalence of herpes zoster, and to determine the genotype of VZV.

Materials and Methods

Serum IgG antibody titer was measured in 399 patients. Lifetime prevalence of herpes zoster was evaluated through a survey of 2,054 participants. VZV was isolated by cell culture technique using MRC-5 cells. To determine the genotype of VZV, ORF 22, 38, 54, 62 were amplified by PCR, and after digestion of the PCR products with enzymes pstI, bglI, and smaI, restriction-fragment-length-polymorphism (RFLP) was analysed. The amplified ORF 22 PCR product was sequenced and checked for single nucleotide polymorphisms.

Results

The overall seroprevalence of VZV IgG in adults was 93.9% (375/399). The overall lifetime prevalence of herpes zoster was 13.7% (282/2,054). Of the patients with herpes zoster, 17.7% (50/282) of patients experienced postherpetic neuralgia for more than one month. All 22 VZV isolates were of J genotype; 21 (95.4%) isolates were all pstI+ bglI+ smaI-, and 1 (4.5%) isolate was pstI- bglI+ smaI- (pOka) genotype.

Conclusions

The seroprevalece of VZV IgG antibody was 93.9% in adults. The lifetime prevalence of herpes zoster was 13.7%. The genotype of VZV isolated from adults over 60 years old were all of J genotype.

Figures and Tables

Figure 1
RFLP Pattern of ORF 38, 54, and 62 Product Digested with pstI, bglI, smaI. A) A 350bp ORF 38 product was digested with pstI. The product yielded 2 fragments of 250bp and 100bp in size. B) Digestion of 268bp ORF 62 product with smaI yielded 3 fragments 153bp, 79bp, 36bp in size. C) Digestion of 222bp ORF 54 product with bglI yielded 2 fragments 137bp and 87bp in size.
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Table 1
Sequences of Primers Used to Amplify Sites ORF 22, 38, 54, and 62
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Four sets of primer sequences were used to amplify pstI, bglI, smaI restriction sites in ORF 38, 54, and 62. ORF 22 primer was designed to amplfy a 447bp sized segment for SNP analysis to evaluate M type.

Table 2
Prevalence and Mean titer of VZV IgG Antibody according to Age Groups
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No, number; VZV, varicella zoster virus; SD, standard deviation

Cutoff values were designated <0.8 as negative, 08-1.2 as equivocal and >1.2 as positive. Equivocal specimens were considered positive.

Table 3
Prevalence of Herpes Zoster according to Age Group and Sex
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NA, Not Available

Table 4
Prevalence and Duration of Postherpetic Neuralgia in 282 Patients with a History of Herpes Zoster
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Table 5
RFLP Analysis and Final Genotype of VZV Isolated from 22 Elderly Korean Patients
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*could not be identified ny RFLP analysis. Identified by SNP analysis as J genotype.

Table 6
SNP Analysis of ORF 22 in VZV Isolated from 22 Elderly Korean Patients
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Dumas, Dumas strain (E genotype, Genbank accession no. 9625875); pOka, Oka parental strain (J genotype, Genbank accesion no. 26665422

References

1. Schmader K. Herpes zoster in older adults. Clin Infect Dis. 2001. 32:1481–1486.
crossref
2. Brisson M, Edmunds WJ, Law B, Gay NJ, Walld R, Brownell M, Roos L, De Serres G. Epidemiology of varicella zoster virus infection in Canada and the United Kingdom. Epidemiol Infect. 2001. 27:305–314.
crossref
3. Hope-Simpson RE. The nature of herpes zoster: a long-term study and a new hypothesis. Proc R Soc Med. 1965. 58:9–20.
crossref
4. Donahue JG, Choo PW, Manson JE, Platt R. The incidence of herpes zoster. Arch Intern Med. 1995. 155:1605–1609.
crossref
5. Gilden DH, Kleinschmidt-DeMasters BK, LaGuardia JJ, Mahalingam R, Cohrs RJ. Neurologic complications of the reactivation of varicella-zoster virus. N Engl J Med. 2000. 342:635–645.
crossref
6. Gnann JW Jr, Whitley RJ. Clinical practice. Herpes zoster. N Engl J Med. 2002. 347:340–346.
7. Thomas SL, Hall AJ. What does epidemiology tell us about risk factors for herpes zoster? Lancet Infect Dis. 2004. 4:26–33.
crossref
8. Hope-Simpson RE. Postherpetic neuralgia. J R Coll Gen Pract. 1975. 25:571–575.
9. Kost RG, Straus SE. Postherpetic neuralgia--pathogenesis, treatment, and prevention. N Engl J Med. 1996. 335:32–42.
crossref
10. Population census 2005. Age over 60 years, City and province statistics. KOSIS. Available at: http://www.kosis.kr.Accessed23October2007.
11. Park SY, Kim JY, Kim CD, Kim CW, Lee KS. A clinical study on herpes zoster during the last 10-year-period (1994-2003). Korean J Dermatol. 2004. 42:1531–1535.
12. Kang CI, Choi CM, Hong SS, Kim HB, Kim NJ, Oh MD, Choe KW. The incidence of herpes zoster in otherwise healthy young soldiers of korean army. Infect Chemother. 2006. 38:45–46.
13. Kim SY, Cho BH, Kim JH. A 5 - Year Clinical Study on Herpes Zoster: 1990 - 1994. Korean J Dermatol. 1997. 35:266–272.
14. Shin DY, Koo DW. Statistical analysis of herpes zoster in chuncheon and the northern kangwon province ( 1994-1996 ). Korean J Dermatol. 1998. 36:422–429.
15. Jumaan AO, Yu O, Jackson LA, Bohlke K, Galil K, Seward JF. Incidence of herpes zoster, before and after varicella-vaccination-associated decreases in the incidence of varicella, 1992-2002. J Infect Dis. 2005. 191:2002–2007.
crossref
16. Adams SG, Dohner DE, Gelb LD. Restriction fragment differences between the genomes of the Oka varicella vaccine virus and American wild-type varicella-zoster virus. J Med Virol. 1989. 29:38–45.
crossref
17. Yih WK, Brooks DR, Lett SM, Jumaan AO, Zhang Z, Clements KM, Seward JF. The incidence of varicella and herpes zoster in Massachusetts as measured by the Behavioral Risk Factor Surveillance System (BRFSS) during a period of increasing varicella vaccine coverage, 1998-2003. BMC Public Health. 2005. 5:68.
crossref
18. LaRussa P, Lungu O, Hardy I, Gershon A, Steinberg SP, Silverstein S. Restriction fragment length polymorphism of polymerase chain reaction products from vaccine and wild-type varicella-zoster virus isolates. J Virol. 1992. 66:1016–1020.
crossref
19. Loparev VN, Gonzalez A, Deleon-Carnes M, Tipples G, Fickenscher H, Torfason EG, Schmid DS. Global identification of three major genotypes of varicella-zoster virus: longitudinal clustering and strategies for genotyping. J Virol. 2004. 78:8349–8358.
crossref
20. Kilgore PE, Kruszon-Moran D, Seward JF, Jumaan A, Van Loon FP, Forghani B, McQuillan GM, Wharton M, Fehrs LJ, Cossen CK, Hadler SC. Varicella in Americans from NHANES III: implications for control through routine immunization. J Med Virol. 2003. 70:Suppl 1. S111–S118.
crossref
21. Dayan GH, Panero MS, Debbag R, Urquiza A, Molina M, Prieto S, Del Carmen Perego M, Scagliotti G, Galimberti D, Carroli G, Wolff C, Schmid DS, Loparev V, Guris D, Seward J. Varicella seroprevalence and molecular epidemiology of varicella-zoster virus in Argentina, 2002. J Clin Microbiol. 2004. 42:5698–5704.
crossref
22. Choi HJ, Shim YS, Jeong SY. Susceptibility of health care workers to measles, rubella, and varicella at a university hospital. Infect Chemother. 2003. 35:401–406.
23. Kim OJ, Kim SS, Choi BS, Suh SD, Lee MW, Kim KS, Park MS, Lee JS. Consistency of the low seroprevalence of human herpesvirus 8 and the rarity of kaposi`s sarcoma in south Korea. J Bacteriol Virol. 2001. 31:275–279.
24. Shin HS, Oh HS, Kim SM, Joong KN, Choi HJ, Oh MD, Lee HJ, Choe KW. Prevalence of measles, rubella and varicellazoster antibodies in hospital personnel. Korean J Infect Dis. 1997. 29:29–32.
25. Arvin A. Aging, immunity, and the varicella-zoster virus. N Engl J Med. 2005. 352:2266–2267.
crossref
26. Arvin AM. Humoral and cellular immunity to varicella-zoster virus: an overview. J Infect Dis. 2008. 197:Suppl 2. S58–S60.
crossref
27. Schmader K, Gnann JW Jr, Watson CP. The epidemiological, clinical, and pathological rationale for the herpes zoster vaccine. J Infect Dis. 2008. 197:Suppl 2. S207–S215.
crossref
28. Yawn BP, Saddier P, Wollan PC, St Sauver JL, Kurland MJ, Sy LS. A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction. Mayo Clin Proc. 2007. 82:1341–1349.
crossref
29. Dworkin RH, Schmader KE. Treatment and prevention of postherpetic neuralgia. Clin Infect Dis. 2003. 36:877–882.
crossref
30. Davison AJ, Scott JE. The complete DNA sequence of varicella-zoster virus. J Gen Virol. 1986. 67:1759–1816.
crossref
31. Sauerbrei A, Wutzler P. Different genotype pattern of varicella-zoster virus obtained from patients with varicella and zoster in Germany. J Med Virol. 2007. 79:1025–1031.
crossref
32. Muir WB, Nichols R, Breuer J. Phylogenetic analysis of varicella-zoster virus: evidence of intercontinental spread of genotypes and recombination. J Virol. 2002. 76:1971–1979.
crossref
33. Sengupta N, Taha Y, Scott FT, Leedham-Green ME, Quinlivan M, Breuer J. Varicella-zoster-virus genotypes in East London: a prospective study in patients with herpes zoster. J Infect Dis. 2007. 196:1014–1020.
crossref
34. Loparev VN, Rubtcova EN, Bostik V, Govil D, Birch CJ, Druce JD, Schmid DS, Croxson MC. Identification of five major and two minor genotypes of varicella-zoster virus strains: a practical two-amplicon approach used to genotype clinical isolates in Australia and New Zealand. J Virol. 2007. 81:12758–12765.
crossref
35. Loparev V, Martro E, Rubtcova E, Rodrigo C, Piette JC, Caumes E, Vernant JP, Schmid DS, Fillet AM. Toward universal varicella-zoster virus (VZV) genotyping: diversity of VZV strains from France and Spain. J Clin Microbiol. 2007. 45:559–563.
crossref
36. Sauerbrei A, Zell R, Philipps A, Wutzler P. Genotypes of varicella-zoster virus wild-type strains in Germany. J Med Virol. 2008. 80:1123–1130.
crossref
37. Takayama M, Takayama N, Inoue N, Kameoka Y. Application of long PCR method of identification of variations in nucleotide sequences among varicella-zoster virus isolates. J Clin Microbiol. 1996. 34:2869–2874.
crossref
38. Argaw T, Cohen JI, Klutch M, Lekstrom K, Yoshikawa T, Asano Y, Krause PR. Nucleotide sequences that distinguish Oka vaccine from parental Oka and other varicella-zoster virus isolates. J Infect Dis. 2000. 181:1153–1157.
crossref
39. Gomi Y, Sunamachi H, Mori Y, Nagaike K, Takahashi M, Yamanishi K. Comparison of the complete DNA sequences of the Oka varicella vaccine and its parental virus. J Virol. 2002. 76:11447–11459.
crossref
40. Loparev VN, Argaw T, Krause PR, Takayama M, Schmid DS. Improved identification and differentiation of varicella-zoster virus (VZV) wild-type strains and an attenuated varicella vaccine strain using a VZV open reading frame 62-based PCR. J Clin Microbiol. 2000. 38:3156–3160.
crossref
41. Quinlivan M, Hawrami K, Barrett-Muir W, Aaby P, Arvin A, Chow VT, John TJ, Matondo P, Peiris M, Poulsen A, Siqueira M, Takahashi M, Talukder Y, Yamanishi K, Leedham-Green M, Scott FT, Thomas SL, Breuer J. The molecular epidemiology of varicella-zoster virus: evidence for geographic segregation. J Infect Dis. 2002. 186:888–894.
crossref
42. Barrett-Muir W, Scott FT, Aaby P, John J, Matondo P, Chaudhry QL, Siqueira M, Poulsen A, Yaminishi K, Breuer J. Genetic variation of varicella-zoster virus: evidence for geographical separation of strains. J Med Virol. 2003. 70:Suppl 1. S42–S47.
crossref
43. Faga B, Maury W, Bruckner DA, Grose C. Identification and mapping of single nucleotide polymorphisms in the varicellazoster virus genome. Virology. 2001. 280:1–6.
crossref
44. Park HK, Seoh JY. Antigen analysis and restriction fragment length polymorphysm of the polymerase chain reaction products of Varicella-Zoster virus wild strains isolated in Korea. J Korean Soc Microbiol. 1997. 32:265–274.
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