ArticleJournal of the American Heart Association2025
Evidence of Varicella Zoster Virus Reactivation in Children With Arterial Ischemic Stroke: Results of the VIPS II Study.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
8 citing papers in PubMed.
- Varicella zoster virus infection.Nature reviews. Disease primers · 2026Review
- Metagenomic analysis of blood virome in ischemic stroke reveals an increase in herpesvirus transcripts and host immune activation.Genome medicine · 2026Article
- Varicella-zoster virus infection of the central nervous system: clinical features and proteomic analysis of cerebrospinal fluid.Frontiers in cellular and infection microbiology · 2026Article
- Post-Varicella Arteriopathy as a Cause of Pediatric Arterial Ischemic Stroke: A Systematic Review and Case Report.Brain sciences · 2025Review
- Hemichorea as a primary manifestation of varicella-zoster virus neuroinfection in a child - a case report and review of literature.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Review
- A fresh look at varicella vaccination.Human vaccines & immunotherapeutics · 2025Review
- Cerebral vasculitis as a severe complication of acute infectious meningoencephalitis-a case series of five different pathogens.Wiener medizinische Wochenschrift (1946) · 2025Article
- Intracranial hemorrhagic vasculitis in a child with varicella zoster virus infection: a case report.Frontiers in medicine · 2025Article
Corrections and comments
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11 authors.
Funding
Abstract
backgroundVaricella zoster virus (VZV) has historically been associated with focal cerebral arteriopathy and arterial ischemic stroke (AIS) in children, and risk of AIS and myocardial infarction in adults. The VIPS (Vascular Effects of Infection in Pediatric Stroke) II study aimed to determine whether VZV remains a pediatric stroke trigger in an era of routine VZV vaccination.
methodsThis 22-center prospective cohort study enrolled 205 patients (28 days to 18 years; median, 11.6 years) with spontaneous AIS (December 2016 to January 2022) in North America and Australia, performed parental interviews, and collected baseline (hyperacute [≤72 hours; n=194] and acute [4-6 days; n=181]) and convalescent (1-6 weeks; n=74) serum samples. A virology research laboratory measured VZV IgM and IgG titers by an in-house ELISA in patients with AIS and 95 unmatched well control children.
resultsBaseline serologies indicated prior VZV exposure in 198 patients (97%). Parents recalled prior VZV vaccination in 160 (78%) and remote chickenpox in 3 (1.4%). Twenty patients (9.8%) had serologic evidence of recent VZV reactivation at the time of their stroke; all were asymptomatic. All had remote VZV exposure with VZV vaccination (median) 6.1 years prior. We observed recent VZV reactivation in patients with focal cerebral arteriopathy (4/32 [12.5%]) but not with arterial dissection or moyamoya. All 95 controls had serologic evidence of prior VZV exposure and 3 (3.1%) had recent VZV reactivation.
conclusionsOne in 10 patients with childhood AIS had recent, asymptomatic VZV reactivation. In a vaccinated population, VZV may continue to play a modest role in childhood stroke pathogenesis.
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