Low antibody avidity in elderly chickenpox patients

Schoub, Barry D.; Blackburn, N. K.; Johnson, Susan M.; McAnerney, Johanna M.; Miller, B. A.

doi:10.1002/jmv.1890370207

Cited by 21 publications

(8 citation statements)

References 17 publications

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“…However, the use of one or other denatur- ing agent is affected by the type of organism inducing the Ab response and the strength of the denaturing effect caused and must be investigated for each case. The breakpoints revised in the literature for considering the presence of low-avidity Abs vary from 70-75% [23][24][25][26][27][28][29][30][31][32][33][34][35][36] and 50% [16,27], depending on the denaturing agent employed, the type of organism in question, and the requirements of the individual author. The former authors who argue in favour of higher breakpoints use 6-molar urea or diethylamine as a denaturing agent.…”

Section: Discussionmentioning

confidence: 99%

Reliability of four methods for the diagnosis of acute infection by Epstein‐Barr virus

Marrero-Gutiérrez¹,

Rodríguez²,

Maroto³

et al. 1997

J. Clin. Lab. Anal.

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We studied the reliability of new indirect tests in the diagnosis of acute infection by Epstein-Barr virus (EBV). Studied for all samples were: method 1, the heterophil antibodies (Abs) (Monolatex, Biokit, Germany); method 2, the IgM Abs to EBV with ELISA tests (antigen pools, Enzygnost, Behringwerke, Germany); method 3, EA (Biotest Diagnostics, Germany); and method 4, the IgG avidity test. The reliability of the four tests for the detection of primary infection by EBV was: sensitivity (method 1: 89.1%; method 2: 100%; method 3: 79.7%; method 4: 99%); specificity (method 1: 98%; method 2: 100%; method 3: 84%; method 4: 100%); positive predictive value (method 1: 97.6%; method 2: 100%; method 3: 73.6%; method 4: 100%), and negative predictive value (method 1: 90.7%; method 2: 100%; method 3:84%; method 4: 99%). The IgG avidity test (method 4) is simple and automated in the laboratory and is very useful for ascertaining, from a single sample, the time since infection. It is criteria of recent primoinfection higher levels than 55% of IgG with low avidity for the antigen. The investigation of the Abs to antigen pools (method 2) by ELISA of virus had a high reliability, but the investigation of heterophil Abs by latex (method 1) and the Abs IgM to EA (method 2) were lacking in sensibility regarding their use in the diagnosis of the primoinfection. J. Clin. Lab. Anal. 11:78-81.

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Section: Discussionmentioning

confidence: 99%

Reliability of four methods for the diagnosis of acute infection by Epstein‐Barr virus

Marrero-Gutiérrez¹,

Rodríguez²,

Maroto³

et al. 1997

J. Clin. Lab. Anal.

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“…Microbiology laboratory in mother-child VZV infection nuclear proteins (p32 and p36) mature differently from those against surface glycoproteins (they are more likely to have low avidity) [484] , and establishing a cut-off value can sometimes be arbitrary [30] . The results are different in immunocompromised and immunocompetent subjects [488,489] , and age may also be a factor [490,491] : Low avidity may be found during reinfections in the elderly and in some cases of recurrent infections in children [485,492] . Other things to consider are the time since vaccination (first or second dose), and the time since exposure or the onset of rash: Individual situations (low responders to vaccination can maintain lower antibody titres and low avidity over time) [393] ; and the type of infection (e.g., it is not useful in cases of BV because it is likely that vaccinated subjects already have high avidity in response to the vaccination itself) [30] .…”

Section: Igg Aviditymentioning

confidence: 98%

“…Avidity is generally expressed as a percentage of antibody titre by comparing the results with and without the denaturing agent [484][485][486] , which can be helpful in differentiating primary infection (low avidity) and past infection, reactivations or re-infections (high avidity), and then discriminating varicella and herpes zoster [287,393,454,484,487] . It has also been used to differentiate patients with past infection and naïve patients after vaccination [393] , although a number of points need to be borne in mind.…”

Section: Igg Aviditymentioning

confidence: 99%

Microbiology laboratory and the management of mother-child varicella-zoster virus infection

Paschale

Clerici

2016

WJV

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Varicella-zoster virus, which is responsible for varicella (chickenpox) and herpes zoster (shingles), is ubiquitous and causes an acute infection among children, especially those aged less than six years. As 90% of adults have had varicella in childhood, it is unusual to encounter an infected pregnant woman but, if the disease does appear, it can lead to complications for both the mother and fetus or newborn. The major maternal complications include pneumonia, which can lead to death if not treated. If the virus passes to the fetus, congenital varicella syndrome, neonatal varicella (particularly serious if maternal rash appears in the days immediately before or after childbirth) or herpes zoster in the early years of life may occur depending on the time of infection. A Microbiology laboratory can help in the diagnosis and management of mother-child infection at four main times: (1) when a pregnant woman has been exposed to varicella or herpes zoster, a prompt search for specific antibodies can determine whether she is susceptible to, or protected against infection; (2) when a pregnant woman develops clinical symptoms consistent with varicella, the diagnosis is usually clinical, but a laboratory can be crucial if the symptoms are doubtful or otherwise unclear (atypical patterns in immunocompromised subjects, patients with post-vaccination varicella, or subjects who have received immunoglobulins), or if there is a need for a differential diagnosis between varicella and other types of dermatoses with vesicle formation; (3) when a prenatal diagnosis of uterine infection is required in order to detect cases of congenital varicella syndrome after the onset of varicella in the mother; and (4) when the baby is born and it is necessary to confirm a diagnosis of varicella (and its complications), make a differential diagnosis between varicella and other diseases with similar symptoms, or confirm a causal relationship between maternal varicella and malformations in a newborn. Core tip: Although varicella during pregnancy is infrequent and congenital varicella syndrome (CVS) is rare, every available means should be used to prevent and diagnose them. Microbiology laboratories can be crucial in these situations: Evaluating a mother's immune status with sensitive and specific tests for the detection of antibodies; allowing a rapid diagnosis with molecular biology tests when a clinical manifestation may be due to different etiologies; following pregnant women with varicella for the prenatal diagnosis of CVS with close collaboration between molecular biology investigators and specialists in imaging diagnostics.De Paschale M, Clerici P. Microbiology laboratory and the management of mother-child varicella-zoster virus infection. World

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“…Using 8 M urea we obtained results similar to those of other authors who used this or another denaturing substance. The literature reviewed on the use of low-avidity IgC antibodies in the diagnosis of infection in general gives breakpoints varying from 70% to 85% [13,21,23,24] to 50% [25,26]. This depends on whether the approach is used for determining primary infection, reactivation or reinfection, on the denaturing substance used and on the different human pathogens being studied.…”

Section: Id(-) I D ( + )mentioning

confidence: 99%

Detection of IgA and low-avidity IgG antibodies for the diagnosis of recent active toxoplasmosis

Gutiérrez¹,

Rodríguez²,

Piédrola³

et al. 1997

Clinical Microbiology and Infection

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Objective: To determine the clinical value of testing IgA and the avidity of IgG (by two commercial systems) for the detection of recent active toxoplasmosis (RAT), and t o study the IgG avidity during the course of infection.Methods: The IgA was tested by a capture ELISA (Pasteur, France) and the avidity of IgG was determined by two modified commercial indirect ELSA methods (Sorin, Italy; Behringwerke, Germany) in 12 patients who were not immunosuppressed (group I) and 57 healthy subjects with a past infection by Toxoplasrna gondii (group 11). Results:IgA was present in 75% of patients from group I and 21% of subjects from group II. The reliabilityfor diagnosis of RAT was: sensitivity 75%, specificity 84%, positive predictive value 52.9% and negative predictive value 93.3%. In group I, 91.7% of patients had more than 50% low-avidity IgG, by both methods; in group 11, 21% of subjects had lowavidity IgG at levels from 40% to 50%, by both methods. The diagnostic reliability of the two methods for the detection of low-avidity IgG in the first samples of RAT was similar when a breakpoint of 50% was used, with values of: sensitivity 91.7%, specificity loo%, positive predictive value 100% and negative predictive value 98%. Conclusions:The study of IgA is not on its own adequate for diagnosis of RAT. However, testing the avidity of IgG is more reliable for the diagnosis of RAT, in studies of one serum sample or sequential samples.

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Low antibody avidity in elderly chickenpox patients

Cited by 21 publications

References 17 publications

Reliability of four methods for the diagnosis of acute infection by Epstein‐Barr virus

Reliability of four methods for the diagnosis of acute infection by Epstein‐Barr virus

Microbiology laboratory and the management of mother-child varicella-zoster virus infection

Detection of IgA and low-avidity IgG antibodies for the diagnosis of recent active toxoplasmosis

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