Abstract

Previous investigations of the humoral immune response to varicella-zoster virus (VZV) infection were hampered by the insensitivity of the complement-fixing antibody test. Development of the indirect fluorescent method for detecting antibody to VZV-membrane antigen provided a means of separating immune from susceptible individuals and confirmed the ability of zoster immune globulin (ZIG) to attenuate disease if given to susceptible children shortly after exposure. Because of the important role of antibody in modifying clinical disease, we have evaluated the neutralizing antibody response in neonates and older children with VZV infection. Utilizing a newly developed ‘semi-micro’ plaque reduction assay we found (i) that the titer of neutralizing antibody was enhanced 2-4 fold by the addition of complement and (ii) that complement-dependent neutralizing antibody occasionally was detectable when anti-membrane antibody was negative (<1:2). These results suggest that neutralizing antibody titers may be required to fully assess the VZV immune status of exposed newborn and immuno-suppressed children. In addition, this test may define the role of humoral immunity in modulating VZV reactivation.

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