Severe eczema herpeticum is associated with prolonged depression of cell-mediated immunity to herpes simplex virus

Nine patients with eczema herpeticum (EH) and 2 with atopic eczema and recurrent cold sores were investigated for cell-mediated immunity (CMI) and antibodies (Ab) to herpes simplex virus (HSV). All patients had Ab to HSV and a high lymphoproliferation response to concanavalin A and all but 3 showed lymphoproliferation to HSV antigens. These 3 patients had very severe EH and absent CMI to HSV for many months after clinical recovery despite normal Ab and concanavalin A responses. In 2 of them, depletion of CD8+ T cells by panning restored the lymphoproliferative response to HSV. Thus their absent CMI may be due to suppressor cell function rather than lack of responsive cells.