Reduction of the number of immunocompetent cells in the acute stage of herpes zoster

Circulating and in situ mononuclear cell subsets were phenotypically characterized during both the acute and convalescent phase of herpes zoster infections in 14 patients. In peripheral blood a significant reduction in the absolute number of Leu 4+ T cells, Leu 2a+ suppressor/cytotoxic T cells, Leu 3a+ helper/inducer T cells, Leu 7+ killer cells, and B1+ B cells were found during the acute stage compared to convalescents and normal controls. In contrast no change in the absolute number of MO2+ monocytes was seen in the acute stage of the disease. During convalescence a return to normal values in the lymphocyte subsets and killer cells was seen within 1-2 months after the initial disease presentation. In skin biopsy specimens from 4 of the 14 patients with active herpes zoster lesions the cellular infiltrate consisted of T cells (Leu 4+) the majority being helper/inducer T cells (Leu 3a+). Most of the cells expressed HLA-DR (Ia) antigens and were according to this in an activated state. The observed changes in effector and regulatory cell numbers may have implications for the acquisition of Varicella-zoster virus infections, the immune deficiency state associated with the disease, and/or the immune response to resolve the infection.