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The Problem
Over 95% of people have been infected by varicella zoster virus (VZV), which causes chickenpox. After infection, the virus lies dormant in nerve cells, reactivating periodically in predisposed individuals. In around 25% to 35% of infected people, reactivation leads to herpes zoster (or shingles), which may be complicated by serious neurological and ocular disorders. Several population studies have shown a link between VZV reactivation and stroke in different geographic settings. Although a herpes zoster vaccine became available in England & Wales in 2013, it is only offered to limited groups aged over 70 years. Further research into populations at risk of VZV-associated stroke is urgently needed to improve vaccine targeting.
Our Research
We are using novel linked data sources to investigate associations between sub-clinical VZV reactivation and a range of vascular outcomes. This involves testing serum samples collected through the Health Survey for England using a highly sensitive time-resolved immunofluoroassay for VZV antibodies as a marker of virus reactivation and linking results to population data from Hospital Episode Statistics. The aim is to characterise the population at risk of vascular events associated with VZV reactivation to inform design of clinical trials of personalised preventive interventions.
Themes
Diseases
People
Charlotte Warren-Gash
Andrew Hayward
Collaborators
Judy Breuer, UCL Division of Infection & Immunity
Jennifer Mindell, UCL Epidemiology & Public Health
Publications
Herpes zoster and vascular risk. Warren-Gash C & Breuer J. Chapter in ‘The Varicella Zoster Virus: Varicella, Herpes Zoster, Postherpetic Neuralgia and Persistent Disease Activity: A Focus on Treatment and Prevention’. Eds Watson C, Gershon AG, Oxman N. Springer. 2016 In press.