Serum and cerebrospinal fluid neurofilament light chain in patients with central nervous system infections caused by varicella-zoster virus
Artikel i vetenskaplig tidskrift, 2020

Varicella-zoster virus (VZV) is a common cause of viral central nervous system (CNS) infection, and patients may suffer from severe neurological sequelae. The biomarker neurofilament light chain (NFL) is used for assessment of neuronal damage and is normally measured in cerebrospinal fluid (CSF). Novel methods have given the possibility to measure NFL in serum instead, which could be a convenient tool to estimate severity of disease and prognosis in VZV CNS infections. Here, we investigate the correlation of serum and CSF NFL in patients with VZV CNS infection and the association of NFL levels in serum and CSF with different VZV CNS entities. NFL in serum and CSF was measured in 61 patients who were retrospectively identified with neurological symptoms and VZV DNA in CSF detected by PCR. Thirty-three herpes zoster patients and 40 healthy blood donors served as control groups. NFL levels in serum and CSF correlated strongly in the patients with VZV CNS infection. Encephalitis was associated with significantly higher levels of NFL in both serum and CSF compared with meningitis and Ramsay Hunt syndrome. Surprisingly, herpes zoster controls had very high serum NFL levels, comparable with those shown in encephalitis patients. We show that analysis of serum NFL can be used instead of CSF NFL for estimation of neuronal injury in patients with VZV CNS infection. However, high levels of serum NFL also in patients with herpes zoster, without signs of CNS involvement, may complicate the interpretation.


Central nervous system (CNS)

Varicella-zoster virus (VZV)



Tobias Tyrberg

Göteborgs universitet

Staffan Nilsson

Chalmers, Matematiska vetenskaper, Tillämpad matematik och statistik

Kaj Blennow

Sahlgrenska universitetssjukhuset

Göteborgs universitet

Henrik Zetterberg

Göteborgs universitet

University College London (UCL)

Sahlgrenska universitetssjukhuset

UK Dementia Research Institute

Anna Grahn

Göteborgs universitet

Journal of NeuroVirology

1355-0284 (ISSN) 1538-2443 (eISSN)

Vol. 26 5 719-726



Reumatologi och inflammation




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