Varicella-zoster virus

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Varicella-zoster virus (VZV) is a prevalent human pathogen responsible for chickenpox and can later reactivate as herpes zoster. Despite having the smallest genome among human herpesviruses, VZV encodes over 70 proteins. Molecular epidemiology, utilizing genomic sequencing, has revealed the global distribution of VZV across distinct clades, reflecting human migration patterns. Modern molecular techniques are enhancing our understanding of how VZV gene products facilitate the viral life cycle, including replication, virion assembly, egress, and host cell takeover by modulating cell cycle regulation and antiviral responses. Research is advancing in understanding VZV pathogenesis, focusing on its interactions with keratinocytes, T cells, dendritic cells, and neurons during primary infection, latency, and reactivation, as well as the host's innate and adaptive responses. Comparative studies with simian varicella virus have provided new insights into molecular virology and pathogenesis. Notably, VZV is the only human herpesvirus with approved vaccines for preventing both primary and recurrent infections, which have significantly benefited public health. This review highlights recent achievements and emerging directions in VZV basic and clinical research.