J Korean Med Sci.  2023 Jan;38(2):e7. 10.3346/jkms.2023.38.e7.

Diagnostic Usefulness of Varicella Zoster Virus-Specific Immunoglobulin (Ig) A and IgG in Patients With Herpes Zoster

• Choi S
• Moon SM
• Kwon JS
• Kim SH
• Park SY

• KMID: 2537954
• DOI: http://doi.org/10.3346/jkms.2023.38.e7

Abstract

Background
Whether varicella zoster virus (VZV) antibody titer could discriminate patients with herpes zoster (HZ) from healthy controls (HCs) is unclear. We evaluated the diagnostic usefulness of VZV-specific immunoglobulin A (IgA) and immunoglobulin G (IgG) antibodies in patients with confirmed HZ.
Methods
Study subjects comprised patients with confirmed HZ by salivary VZV DNA positivity and control age- and sex-matched HCs. Saliva was collected and concurrent blood samples were obtained on the first visit day (acute phase) and after 4 weeks (convalescent phase) from 44 HZ patients. All 44 healthy volunteers provided blood and saliva samples once.
Results
The median VZV IgA titers in acute-phase (5.2 mIU/mL, P < 0.001) and convalescentphase (15.8 mIU/mL, P < 0.001) serum samples from HZ patients were significantly higher than those in HCs (1.35 mIU/mL). VZV IgA positivity was detected in about 20% of acute phase serum and convalescent-phase serum of HZ patients. The median VZV IgG antibody titers of HZ patients during acute (1,471.0 mIU/mL, P < 0.001) and convalescent (4,934.7 mIU/mL, P < 0.001) phases were significantly higher than the median titer reported for HCs (591.6 mIU/mL). A four-fold or higher increase in VZV IgG antibody titer was observed in 36.4% of HZ patients.
Conclusion
VZV IgA positivity or four-fold or higher increase in VZV IgG antibody titers were not detected in a satisfactory proportion of HZ-infected patients. However, the titer of VZV IgA or IgG antibody particularly in convalescent-phase sera may discriminate HZ patients from HCs.

Keyword

Varicella Zoster Virus (VZV); Herpes Zoster; VZV Immunoglobulin A; VZV Immunoglobulin G

Figure

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  Fig. 1 Level of VZV-specific IgA (A) and IgG antibodies (B) among 44 herpes zoster patients and 44 HC subjects, depicted on a log-scale. Bars show the median and interquartile range.VZV = varicella zoster virus, IgA = immunoglobulin A, IgG = immunoglobulin G, HC = healthy control, HZ = herpes zoster.

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  Fig. 2 Receiver operating characteristic curves were plotted for varicella zoster virus immunoglobulin A (A) and immunoglobulin G (B) levels to assess their diagnostic performance for discriminating HZ-positive samples from HZ-negative samples.HZ = herpes zoster.

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