Epidemiology and Infection

Original Papers

Herpes zoster

Assessment of skin test with varicella-zoster virus antigen for predicting the risk of herpes zoster

Y. OKUNOa1 c1, Y. TAKAOa1a2, Y. MIYAZAKIa1, F. OHNISHIa1, M. OKEDAa1, S. YANOa1, H. KUMIHASHIa1, Y. GOMIa1, K. MAEDAa1, T. ISHIKAWAa1, Y. MORIa3a4, H. ASADAa5, H. ISOa2 and K. YAMANISHIa4 for the Shozu Herpes Zoster (SHEZ) Study Group

a1 Kanonji Institute, The Research Foundation for Microbial Diseases of Osaka University, Kanonji, Kagawa, Japan

a2 Public Health, Department of Social and Environmental Medicine, Osaka University, Graduate School of Medicine, Osaka, Japan

a3 Division of Clinical Virology, Department of Microbiology and Infectious Diseases, Kobe University Graduated School of Medicine, Kobe, Japan

a4 National Institute of Biomedical Innovation, Osaka, Japan

a5 Department of Dermatology, Nara Medical University School of Medicine, Nara, Japan


The Shozu Herpes Zoster (SHEZ) Study was designed to clarify the incidence of and predictive and immunological factors for herpes zoster in a defined community-based Japanese population. As part of this series, a total of 5683 residents aged ≥50 years received a varicella-zoster virus (VZV) skin test with VZV antigen, and 48 h later, the erythema and oedema were assessed by measuring the longest diameter. The diameters of both the erythema and oedema decreased with the increasing age of the subject. Sixty-three subjects contracted herpes zoster within a year after receiving the VZV skin test. Analysis of the herpes zoster incidence rate vs. the skin test reaction revealed that the shorter the diameter of erythema or oedema, the greater the likelihood of herpes zoster. These results demonstrated that the VZV skin test is an excellent surrogate marker for predicting the risk of herpes zoster.

(Received June 01 2012)

(Revised October 25 2012)

(Accepted November 06 2012)

(Online publication December 10 2012)

Key words

  • Cell-mediated immunity;
  • herpes zoster;
  • skin test;
  • surrogate marker;
  • varicella-zoster virus


c1 Author for correspondence: Dr Y. Okuno, Kanonji Institute, The Research Foundation for Microbial Diseases of Osaka University, 2-9-41, Yahata-cho, Kanonji, Kagawa 768-0061, Japan. (Email: yokuno@mail.biken.or.jp)