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Varicella zoster virus
(section)
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== Latency and reactivation == After initial infection, VZV establishes a latent infection in the trigeminal nerve and dorsal root ganglia, most predominantly in 87% of the nuclei of neurons of the trigeminal ganglia, as VZV is neurotropic (preferentially targets neural tissue). VZV infects less than 0.1% of non-neuronal cells. It is present in the ganglia of more than 90% of adults.<ref name=":1">{{Cite journal | last = Kennedy | first = Peter G. E. | last2 = Gilden | first2=Donald H. | last3 = Cohrs | first3=Randall J. | last4 = Bloom | first4 = David C. | last5 = Mitchell | first5 = Bradley M. | date = 2003-03-01 | title = Herpes simplex virus-1 and varicella-zoster virus latency in ganglia|url=https://link.springer.com/article/10.1080/13550280390194000|journal=Journal of NeuroVirology|language=en|volume=9|issue=2|pages=194β204|doi=10.1080/13550280390194000|issn=1538-2443}}</ref> Virus gene transcription during latency is epigenetically regulated by at least 6 genes. The expression of gene 63 is the indicator of VZV latency.<ref>{{Cite journal | last =Cohrs | first = Randall J. | last2 = Kennedy | first2 = Peter GE | date = 2010-11-01 | title = Varicella-zoster virus human ganglionic latency: a current summary|url=https://link.springer.com/article/10.1007/BF03210846|journal=Journal of NeuroVirology|language=en|volume=16|issue=6|pages=411β418|doi=10.1007/BF03210846|issn=1538-2443}}</ref> Thus, reactivation can occur either spontaneously or following a triggering factor.<ref name=":1" /> The latency burden of VZV seems to correlate with the severity of the primary illness.<ref>{{Cite journal | last =Levin | first = Myron J. | last2 = Smith | first2 = Jeffrey G. | last3 = Kaufhold | first3=Robin M. | last4 = Barber | first4=Debra | last5 = Hayward | first5 = Anthony R. | last6 = Chan | first6 = Christina Y. | last7 = Chan | first7 = Ivan S.F. |last8 = Li | first8 = David J.J. | last9 = Wang | first9 = William | date = 2003-11-01 | title = Decline in varicella-zoster virus (VZV)-specific cell-mediated immunity with increasing age and boosting with a high-dose VZV vaccine|url=https://www.ncbi.nlm.nih.gov/pubmed/14593591|journal=The Journal of Infectious Diseases|volume=188|issue=9|pages=1336β1344|doi=10.1086/379048|issn=0022-1899|pmid=14593591}}</ref>
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