Chicken Pox Virus Linked to Inflammatory Disease in the Elderly
The medical community has long established that the chicken pox virus may reactivate later in life and manifest as shingles in the elderly. Now, a new study in Neurology links the same virus to giant cell arteritis (GCA)—a condition that inflames blood vessels on the temples and scalp of people over the age of 50.
“Our study, which is the largest to date, basically indicates that the varicella-zoster virus (VZV) is found with great frequency in the temporal arteries of patients with GCA, and is likely the cause of the disease,” says lead study author Don Gilden, MD, Professor of Neurology at the University of Colorado School of Medicine in Denver.
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“We’ve known for decades that the virus reactivates in elderly people and that shingles is the most common complication of reactivation. Now we know that this is one more disease it produces,” Gilden says.
Until now, the cause of GCA has always been uncertain. Causing swelling and tenderness of the arteries on the scalp and temples of people over age 50, this relatively rare condition affects an estimated 29 out of 100,000 people.
However, this potentially life-threatening condition is the most common type of inflammation of the blood vessels in the elderly and can also cause sudden blindness or stroke. Symptoms include a new severe headache, scalp tenderness, jaw discomfort, blurred vision, fever, weight loss, and fatigue.
For the study, Gilden and his colleagues looked for evidence of the virus in 13 temporal artery biopsies of people over age 50 who had died and had no previous symptoms of GCA and in 84 temporal artery biopsies of people over the age of 50 who had GCA.
They found VZV in 74% of the biopsies with GCA and in only 8% of the normal skin biopsies. These findings could directly affect future treatment considerations for patients with GCA.
“GCA has formerly been treated with steroids to cut down the inflammatory response but now that we know that VZV is likely the cause, health care providers may also be able to treat the condition with anti-viral agents, which would probably reduce the complications of the disease,” Gilden says.
It may also mean that the herpes zoster vaccine could be helpful in protecting against GCA. Recommended for people ages 60 and older, the vaccine has been shown to decrease the incidence of virus over a three-year period. Studies have shown that people who were vaccinated had 50% less shingles than a placebo group.
“Although it hasn’t been studied, it’s likely that there would be less GCA in the vaccinated population as well but that would be hard to determine because the disease so much less common than shingles,” Gilden says.
He emphasizes that more research is needed to confirm the association between VZV and GCA and also to explore its potential implications for treatment and prevention.
—Colleen Mullarkey
Reference:
Gilden D, White T, Khmeleva N, Heintzman A, Choe A, Boyer PJ, et al. Prevalence and distribution of VZV in temporal arteries of patients with giant cell arteritis. Neurology. 18 February 2015. [Epub ahead of print].