Abstract: 【Abstract】 Objective To investigate positive rates of varicella-zoster virus （VZV） DNA in blood and saliva samples, as well as in swab samples from lesions and clothes in contact with lesions in patients with acute herpes zoster, and to explore their clinical significance. Methods Patients with confirmed herpes zoster were collected from Department of Dermatology, Shenzhen Hospital, Southern Medical University from April 2019 to August 2020. Fluorescence-based quantitative PCR was performed to detect VZV DNA in blood and saliva samples, lesion and cloth swab samples from the patients before and after antiviral treatment. Chi-square test was used to compare the positive rate of VZV DNA in saliva samples between patients with herpes zoster on the head, face and neck and those without involvement of the head, face or neck, and changes in the positive rate of VZV DNA in different specimens were analyzed before and after treatment. Results A total of 86 patients with herpes zoster were collected, including 26 males and 60 females aged 52.65 ± 14.83 years, with a disease duration being 5.23 ± 2.10 days. The positive rate of VZV DNA in the saliva samples was significantly higher in the 24 patients with herpes zoster on the head, face and neck （41.67%, 10/24） than in the 62 patients without involvement of the head, face or neck （12.90%, 8/62; χ2 = 7.63, P < 0.05）. Both pre- and post-treatment blood samples were collected from 37 patients, saliva samples from 35, lesion swab samples from 28, and cloth swab samples from 27. Before the treatment, the positive rates of VZV DNA in the blood, saliva, lesion and cloth swab samples were 86.49% （32/37）, 22.86% （8/35）, 92.86% （26/28） and 88.89% （24/27） respectively, which decreased to 51.35%, 8.57%, 89.29% and 85.18%, respectively, after 6.82 ± 2.23 days of treatment. The positive rate of VZV DNA significantly differed before and after treatment only in the blood samples （χ2 = 9.60, P = 0.003）, while showed no significant difference in the other specimens （all P > 0.05）. Conclusion The positive rate of VZV DNA in the saliva samples was significantly higher in the patients with acute herpes zoster on the head, face and neck than in those without involvement of the head, face or neck, and that in the cloth swab samples was relatively high before and after antiviral treatment.

Key words: Herpes zoster, Herpesvirus 3, human, Saliva, Lesion-contacted clothes