The role of VariZIG in pregnancy

Abstract

Varicella infection during pregnancy is associated with serious maternal and fetal complications such as congenital varicella syndrome, maternal pneumonia and neonatal varicella. Pregnant women are ineligible to receive the varicella vaccination, thus women who lack evidence of immunity to varicella are at an increased risk for developing a varicella infection if exposed to a contagious individual. Presently, post-exposure prophylaxis involves the administration of a varicella zoster immunoglobulin (VariZIG™) to prevent or reduce the severity of an infection. The US FDA recently approved VariZIG for licensure and recommend that it be administered as soon as possible following VZV exposure, ideally within 96 h for greatest effectiveness. The following review critically examines the role of VariZIG in post-exposure prophylaxis of varicella during pregnancy.

Varicella zoster immune globulin (VARIZIG) administration up to 10 days after varicella exposure in pregnant women, immunocompromised participants, and infants: Varicella outcomes and safety results from a large, open-label, expanded-access program

“…In the current study, the rate of varicella in pregnant women was much lower, at 7.3%. Rates of varicella-associated complications such as pneumonia reportedly occur in 2.5% to 20% of varicella cases in pregnant women [13,36]; no pregnant women developed pneumonia in the current study. The rate of varicella in the current study (7.3%) was lower than previously reported (29%) in a randomized controlled trial comparing VARIZIG and VZIG (discontinued 2006) [29].…”

Regarding “Safety and varicella outcomes after varicella zoster immune globulin administration in pregnancy”

“…It should be remembered that, in the absence of any intervention, the expected rate of primary infection in susceptible contact is about 90% following exposure to a case of varicella, 3 while VZV transmission from herpes zoster occurs in less than 20% of household contacts. 4 As known, the different rate of transmission is related to the different mode of viral transmission: airborne and direct contact for varicella vs direct contact only for herpes zoster.…”

Herpes Zoster and Immunogenicity and Safety of Zoster Vaccines in Transplant Patients: A Narrative Review of the Literature

“…Varicella-zoster immune globulin (VZIG) is a purified human IgG with high titers of antibodies to VZV and used to provide passive immunization for seronegative patients exposed to VZV ( 98 ). In December 2012, FDA approved a VZV immune globulin preparation VariZIG (Cangene Corp., Winnipeg, MB, Canada) for use in the U.S. as a post-exposure prophylaxis of varicella ( 99 ).…”