We have previously shown that CTLA-4 expression is specifically upregulated on VZV-specific T cells in individuals with active herpes zoster [21] or patients with VZV-related diseases of the central nervous system such as meningitis or encephalitis with a 100% sensitivity and 100% specificity for individuals with CTLA-4 MFI above the threshold of 3579 [22]. Here, CTLA4 is linked to central nervous system disorder.