What is the pathophysiology of varicella-zoster virus (VZV) reactivation?

Updated: Feb 11, 2021
  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
  • Print

In this latent period, host immunologic mechanisms suppress replication of the virus, but VZV reactivates when the host mechanisms fail to contain the virus. Such failure may result from a wide spectrum of conditions, ranging from stress to severe immunosuppression; occasionally, it follows direct trauma. VZV viremia occurs frequently with chickenpox but also may arise with herpes zoster, albeit with a lower viral load.

Once VZV is activated at the spinal root or cranial nerve neurons, an inflammatory response occurs that also encompasses the leptomeninges; both plasma cells and lymphocytes are noted. This inflammation in the dorsal root ganglion can be accompanied by hemorrhagic necrosis of nerve cells. The result is neuronal loss and fibrosis.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!