Unit Code 800193:
Varicella-Zoster Virus (VZV) Antibody, IgM, Serum
Useful For
Diagnosing acute-phase infection with VZV
Clinical Information
Varicella-zoster virus (VZV), a herpes virus, causes 2 exanthematous
(rash-associated) diseases, chickenpox and herpes zoster (shingles).
Chickenpox is a highly contagious disease usually contracted during
childhood and is characterized by a dermal vesiculopustular rash
that develops in successive crops. Although primary infection results
in immunity to subsequent exposure to chickenpox, the virus remains
latent in the body, localized to the dorsal root or cranial nerve ganglia.
Reactivation of latent infection manifests as herpes zoster. On reactivation,
the virus migrates along neural pathways to the skin, producing a
unilateral rash usually limited to a single dermatome. Reactivation
occurs in older adults and in patients with impaired cellular immunity.
Several populations are at risk of suffering unusually severe reactions
to VZV infections. The infection in pregnant women may spread through
the placenta to the fetus, causing congenital disease in the infant.
Immunocompromised patients in hospitals may contract severe
nosocomial infections from others who have active VZV infections.
Therefore, serologic screening of direct health-care providers
(physicians, allied health-care personnel) and individuals in high-risk
groups is necessary to avoid uncontrolled spread of infection.
While the clinical presentation of VZV infection is generally characteristic,
serologic evaluation of patients with atypical and systemic infections
is often required. For example, it is extremely important to serologically
evaluate patients for the early detection of VZV infections in hospital
settings. Nosocomial spread of VZV infection can be life-threatening
to immunocompromised patients susceptible to infection.
Reference Values
Negative (reported as positive or negative)
See "Virology" in Special Instructions for additional interpretive
information.
Interpretation
A positive IgM result indicates a recent infection with VZV.
A negative result does not rule out the diagnosis of VZV infection.
The specimen may have been drawn before the appearance
of detectable antibodies. Negative results in suspected early VZV
infection should be followed by testing a new specimen in 2-3 weeks.
Cautions
The performance characteristics with individuals vaccinated with
VZV (OKA Strain) have not been established.
The test must be performed on serum. The use of whole blood,
plasma, or cord blood has not been established.
Positive results from cord blood or neonates should be interpreted
with caution.
Results from immunocompromised patients should be interpreted
with caution.
Special Instructions and Forms
| • | Virology |
Clinical Reference
1. Kennedy PG: Latent varicella-zoster virus is located predominantly
in neurons in human trigeminal ganglia. Proc Natl Acad Sci USA
1998;95:4658-4662
2. McPherson RE: Herpes zoster ophthalmicus and the immuno-
compromised host: a case report and review. J Am Optom Assoc
1997;68:527-538
3. Papanicolaou GA, Meyers BR, Fuchs WS, et al: Infectious
ocular complications in orthotopic liver transplant patients.
Clin Infect Dis 1997;24:1172-1177
4. Flamholc L: Neurological complications in herpes zoster. Scand
J Infect Dis 1996;100:35-40
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