Characteristics and long-term prognosis of Danish patients with varicella zoster virus detected in the cerebrospinal fluid, compared with the background population

Lars H Omland, Hanne T Vestergaard, Ram B Dessau, Jacob Bodilsen, Nanna S Andersen, Claus B Christiansen, Svend Ellermann-Eriksen, Lene Nielsen, Christian Ø Andersen, Anne-Mette Lebech, Niels Obel

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND: Risk factors for and long-term outcomes following detection of varicella zoster virus (VZV) DNA in the cerebrospinal fluid (CSF) are unknown.

METHODS: We performed a nationwide population-based cohort study of all Danish residents who had VZV DNA detected in the CSF by polymerase chain reaction (PCR) between 1 January 1997 and 1 March 2016 (VZV cohort; n = 517) and an age- and sex- matched comparison cohort from the general Danish population (n = 9823). We examined potential risk factors and mortality, neurologic morbidity, psychiatric morbidity, redemption of medicine prescribed for the nervous system and social outcomes.

RESULTS: Prior hospital admission, redemption of immunosuppressive medicine, comorbidity and immunosuppressive conditions were associated with detection of VZV DNA in the CSF. Mortality was increased in the VZV cohort, especially during the first year of observation and among patients with encephalitis. Patients in the VZV cohort had an increased risk of dementia and epilepsy. The redemption of antiepileptics and antidepressants was increased in the VZV cohort.

CONCLUSIONS: Immunosuppression and comorbidity are associated with increased risk of detection of VZV DNA in the CSF and the condition is associated with increased mortality and neurological morbidity.

Original languageEnglish
JournalThe Journal of Infectious Diseases
ISSN0022-1899
DOIs
Publication statusE-pub ahead of print - 8. Jan 2021

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