Cell-free DNA Levels in Herpes Zoster: A Cross-sectional Longitudinal Study

Abstract

This study investigates serum cell-free DNA fluctuations in patients with herpes zoster or post-herpetic neuralgia, offering insight into the tissue damage and inflammatory dynamics associated with these conditions. A single-centre combined cross-sectional and longitudinal study was conducted with 59 patients to assess cell-free DNA levels in herpes zoster and post-herpetic neuralgia. Cell-free DNA was extracted from blood samples of patients with herpes zoster or post-herpetic neuralgia and compared with healthy controls. The findings demonstrated elevated cell-free DNA levels in patients with herpes zoster, which remained elevated for 3 months or longer following treat-ment. These results suggest the presence of a subacute inflammatory state after herpes zoster infection. Furthermore, patients who developed post-herpetic neuralgia did not show elevated cell-free DNA levels, while those who did not develop post-herpetic neuralgia exhibited increased levels. This indicates that post-herpetic neuralgia is likely a localized response to prior nerve damage rather than a systemic inflammatory process with acute tissue damage.

Fig. 1

Circulating cell-free DNA (cfDNA) levels in patients with herpes zoster (HZ) vs controls. A significant increase in cfDNA levels (ng/mL) can be seen in patients with HZ compared with the control group (p = 0.00020).

Fig. 2

Circulating cell-free DNA (cfDNA) levels in patients at the time of diagnosis vs at follow-up (3 months later). No significant difference in cfDNA levels. NS = not significant.

Fig. 3

Circulating cell-free DNA (cfDNA) levels in patients with post-herpetic neuralgia (PHN). Group “0” represents herpes zoster (HZ) patients without PHN; group “1” represents patients with PHN. No significant increase in cfDNA levels between patients with PHN and controls. cfDNA levels are significantly higher in HZ patients without PHN (p < 0.001).