Absence of varicella zoster DNA in varicella embryopathy tissue utilizing the polymerase chain reaction.

We have previously examined a case of varicella embryopathy (VE) occurring in a 41-week gestational age infant, showing some of the most severe lesions reported to be associated with the syndrome to date. A previous survey of the postmortem tissue with two anti-varicella zoster antibodies was negative. It was hypothesized that if varicella-zoster virus (VZV) was associated with VE, a latent viral infection might be expected, similar to that occurring in adults infected with VZV. Subsequently, an attempt was made to identify DNA encoding three separate and specific VZV genes using the highly sensitive polymerase chain reaction from formalin-fixed tissues of the central nervous system including cerebral cortex, cerebellum, and brainstem, in addition to frozen tissue of liver, adrenal, and thymus. Although amplifications utilizing primers for a normal human DNA sequence (ME491) demonstrated the ability of the samples to serve as a target for the PCR, none of the samples contained amplifiable VZV DNA. Substitution of biotin 11-dUTP in the PCR and subsequent detection of the biotinylated amplimers resulted in a large increase of the sensitivity of the PCR amplimer detection, but still failed to detect the presence of VZV DNA in the samples. The most likely explanation for these findings suggests a complete destruction of fetal tissue tropic for VZV with a subsequent inability for a latent VZV infection to be established.