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We thank Professor Moiseev and colleagues for showing their interest in our work.1 ,2 While we agree that our study does not completely refute the link between varicella zoster virus (VZV) and giant cell arteritis (GCA), we feel that stronger evidence of a link between VZV and GCA are needed before clinical trials are conducted in which patients with GCA are given antiviral therapy. If VZV, whether clinically overt, subclinical or latent, triggers the onset of GCA, we would have expected a stronger association between herpes zoster and GCA compared with the association of other infections with GCA. Although outside the scope of our study, we agree that the risk of infection following the institution of immunosuppressive therapy, including biological agents, for GCA is extremely important and needs to be further defined.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.