Specific immunoglobulin responses after varicella and herpes zoster

Abstract

SUMMARYThe indirect immunofluorescence technique has been used to titrate the specific immunoglobulins in 200 sera from 64 patients with varicella, and 195 sera from 67 patients with herpes zoster. IgG and IgM antibodies were detected in all patients with varicella, and IgA in 59 (92 %). All three classes of antibody appeared 2-5 days after the onset of the rash, increased virtually simultaneously and reached maximum titres during the second and third weeks. IgG then declined slowly, but never became undetectable and was still present in five subjects who were retested after 2-4 years; it was present in 88 out of 100 healthy young adults and probably persists indefinitely after varicella. IgA and IgM antibodies declined more rapidly and were not detected in specimens taken more than a year after the illness. IgA, however, may possibly persist in some cases since low titres were found in 8 out of 88 young adults who possessed IgG antibody and had presumably had varicella in the past. IgA responses were significantly weaker in children under the age of 6 years than in older children and adults.Six out of 67 patients with zoster were tested at various times before the onset of the rash: IgG antibody was detected in all. IgG was present in all sera taken after the onset of the rash, increased rapidly after 2-5 days, reached maximum titres during the second and third weeks and then declined slowly. IgA antibody was detected in 66 patients (99 %) and IgM in 52 (78 %); both types of antibody followed transient courses, as in varicella.Maximum titres of IgG and complement-fixing antibodies were greater after zoster than after varicella, but the differences were not significant. IgA and IgM titres in young adults with zoster were significantly lower than in older patients, and also lower than in young adults with varicella.Increases in varicella-zoster antibody in patients with herpes simplex virus infections consisted mainly of IgG, sometimes IgA, but never IgM.

Antibody-capture enzyme-linked immunosorbent assays that use enzyme-labelled antigen for detection of virus-specific immunoglobulin M, A and G in patients with varicella or herpes zoster

“…In the present study VZV-IgM was detected in all 18 patients with varicella, in 7 of these (38-9 %) in the acute-phase serum obtained within a few days after onset of symptoms. This is in agreement with the results of others [2,4,8]. Furthermore, VZV-IgM was detected in serum from 13 out of 19 (68-4 %) patients with herpes zoster.…”

“…Similar results have been obtained by others using both indirect assays as well as antibody-capture assays. In these reports VZV-IgM in patients with herpes zoster was detected by indirect radioimmunoassay in 69 % [4], by indirect immunofluorescense in between 50% and 78 % [1,2,8] and by AC-ELISA in between 50 % and 84% [6,7] of patients. In all studies the VZV-IgM response in patients with herpes zoster was found to be of a lesser magnitude compared to the response in patients with varicella and to be relatively shortlived.…”

“…This test, however, is not very sensitive for determination of past infections and requires detection of a significant antibody 166 A. M. VAN LOON AND OTHERS titre rise in paired serum specimens for diagnosis of acute infection. It has been shown previously [1][2][3][4][5][6][7][8] that detection of VZV-specific immunoglobulin M (VZVIgM) antibody allows rapid diagnosis of acute VZV infection. In all patients with varicella, VZV-IgM was found early in the disease using a variety of methods including the indirect immunofluorescence assay [2], the indirect enzyme-linked immunosorbent assay (ELISA) [3] as well as antibody-capture assays using radioactive [4,5,8] or enzyme labels [6,7].…”

“…It has been shown previously [1][2][3][4][5][6][7][8] that detection of VZV-specific immunoglobulin M (VZVIgM) antibody allows rapid diagnosis of acute VZV infection. In all patients with varicella, VZV-IgM was found early in the disease using a variety of methods including the indirect immunofluorescence assay [2], the indirect enzyme-linked immunosorbent assay (ELISA) [3] as well as antibody-capture assays using radioactive [4,5,8] or enzyme labels [6,7]. In contrast, in patients with herpes zoster an IgM response has been reported in between 20% and 98% of patients [1][2][3][4][5][6][7][8].…”

“…In all patients with varicella, VZV-IgM was found early in the disease using a variety of methods including the indirect immunofluorescence assay [2], the indirect enzyme-linked immunosorbent assay (ELISA) [3] as well as antibody-capture assays using radioactive [4,5,8] or enzyme labels [6,7]. In contrast, in patients with herpes zoster an IgM response has been reported in between 20% and 98% of patients [1][2][3][4][5][6][7][8]. Therefore the value of VZV-IgM detection for rapid diagnosis of herpes zoster is less clear.…”