The Relationship Between Esophageal Motility Disorders and Varicella Zoster Virus: A Study Using Salivary DNA

The causes of most esophageal motility disorders (EMDs) remain unknown. Recent reports have suggested a potential association between the EMD achalasia and varicella zoster virus (VZV) reactivation. This study aimed to investigate the relationship between various EMDs and VZV infection.

This was cross-sectional study. The participants in this study underwent high-resolution manometry (HRM) at Chiba University Hospital between 2022 and 2024. Saliva and blood samples were collected from all patients. The presence of VZV DNA in the saliva was determined using nested polymerase chain reaction (PCR) and electrophoresis. VZV-immunoglobulin M and immunoglobulin G antibody titers were measured in the blood samples. Based on the HRM results, the patients were divided into an EMD group and a normal group. The results were compared between these groups.

A total of 72 patients were included. Of these, 32 (44.4%) were in the normal group and 40 (55.6%) were in the EMD group, including 22 with esophagogastric junction (EGJ) outflow disorders (achalasia and EGJ outflow obstruction) and 18 with peristalsis disorders (absent contractility, distal esophageal spasm, hypercontractile esophagus, and ineffective esophageal motility). One patient with absent contractility had a concurrent herpes zoster infection, and VZV DNA was detected in this patient's saliva. However, all other patients tested negative for VZV DNA. No significant difference in VZV antibody titers was observed between the two groups.

VZV DNA in the saliva and VZV antibody titers do not appear to be associated with EMDs.