Quantitation of varicella-zoster virus DNA in patients with Ramsay Hunt syndrome and zoster sine herpete

Varicella-zoster virus (VZV) reactivation causes facial nerve palsy in Rams ay Hunt syndrome (RHS) and zoster sine herpete (ZSH) with and without zoste r rash, respectively. In the present study, we analyzed the VZV DNA copy nu mber in saliva samples from 25 patients with RHS and 31 patients with ZSH u sing a TaqMan PCR assay to determine differences in the viral load between the two diseases. VZV copy number in saliva peaked near the day of the appe arance of zoster in patients with RHS. Consequently, VZV DNA was less frequ ently detected in patients with RHS who exhibited facial palsy several days after the appearance of zoster. These findings suggest that the VZV load i n saliva samples reflects the kinetics of viral reactivation in patients wi th RHS. In addition, VZV DNA was equally detected in saliva from patients w ith RHS and ZSH, and there was no significant difference in the highest vir al copy number between patients with RHS and those with ZSH. The VZV load d oes not appear to reflect a major difference between RHS and ZSH.