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Response to eLetter: ‘Infections in giant cell arteritis and therapeutic implications’ by Moiseev et al
  1. Rennie L Rhee1,
  2. Peter C Grayson2,
  3. Peter A Merkel1,
  4. Gunnar Tomasson3
  1. 1Department of Rheumatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
  2. 2National Institutes of Health/NIAMS, Bethesda, Maryland, USA
  3. 3University of Iceland, Reykjavik, Iceland
  1. Correspondence to Dr Rennie L Rhee, Department of Rheumatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; rennie.rhee{at}

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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.


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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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