Evaluation of Varicella-Zoster Virus Immunoglobulin G in Children With Malignancies on Chemotherapy

Abstract

Background: Varicella-Zoster Virus (VZV) infection in children with different malignancies on chemotherapy has become an alarming problem. There are insufficient data about VZV seroprevalence among patients in Iran. Objectives: The current study was conducted to assess the seroprevalence of VZV serum IgG antibodies in children with malignancies on chemotherapy. Methods: The current single-center cross-sectional study was conducted from January 2018 to December 2019 at Mofid children’s hospital, Tehran, Iran. Five milliliters of blood samples were collected from the patients. Serum samples were then tested in duplicate for the IgG antibody against VZV using Varicella-Zoster ELISA IgG/IgM kit. Results: A total of 54 children with different malignancies were included. Overall, 24 and 30 serum samples were collected from females and males, respectively. The children were five months to 15-years-old with a mean age of 5.5 years. The overall seroprevalence of VZV IgG in the children was 21.1% (n = 13/54). Of patients with positive VZV IgG antibody, 9 (69.2%) were male, and four (30.8%) were female. Besides, Acute Lymphocytic Leukemia (ALL) with 61.1% (n = 33/54) was the most common underlying malignancy among these patients. The prevalence of anti-VZV IgG antibodies was 21.2% (n = 7/33) in the group of children with ALL. The highest seroprevalence of the VZV IgG antibody was seen in 11 to 15-year-old children (n = 3/7; 42.9%). The prevalence rates of IgG antibodies against VZV among children aged 0-2 years, 3-5 years, and 6-10 years were 28.6%, 25.9%, and 7.7%, respectively. Conclusions: The results showed that children with different malignancies on chemotherapy are quite susceptible to chickenpox infection. It is suggested that a safe and effective live attenuated varicella vaccine in line with the WHO recommendations be incorporated into Iran’s national immunization program for children with various malignancies.