Anti-varicella Zoster Virus Antibody Research Articles

Waning Time of Maternally Derived Anti-Hepatitis A and Anti-Varicella Zoster Virus Antibodies

Objective The objective of this study was to investigate the persistence of maternally derived antibodies to hepatitis A (anti-HAV) and varicella zoster (anti-VZV) viruses to determine the optimal time of vaccination of infants. Materials and Methods This study was conducted between 2011 and 2012 at the Gazi University Hospital. Blood samples were collected from healthy infants' cord blood and at 12th, 18th, and 24th months of age. Anti-HAV and anti-VZV immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies were measured by enzyme-linked immunosorbent assay kit in blood samples. Results A total of 546 infants and children were included in the study; all had blood samples taken at four time points (at birth [cord blood], and at 12, 18, and 24 months). Anti-HAV IgG seropositivity rates in these samples were 77.3, 29.6, 14.8, and 17.7%, respectively (p < 0.05). Corresponding anti-VZV IgG seropositivity rates were 83.3, 21.5, 29.5, and 33.8%, respectively (p < 0.05). Conclusion Anti-HAV and anti-VZV seropositivity rates were lowest at 18 and 12 months, respectively. We suggest that if VZV and hepatitis A vaccines were included in the national vaccination program after the age of 1 year, there should be little interference from passively acquired maternal antibodies.

Pharmacokinetics of a novel human intravenous immunoglobulin 10% in patients with primary immunodeficiency diseases: Analysis of a phase III, multicentre, prospective, open-label study

Intravenous immunoglobulin (IVIG) therapy is commonly used to treat patients with primary antibody deficiency. This prospective, open-label, non-randomised, multicentre, phase III trial investigated the pharmacokinetics of a new 10% liquid IVIG product (panzyga®; Octapharma) in 51 patients aged 2–75 years with common variable immunodeficiency (n = 43) or X-linked agammaglobulinaemia (n = 8). Patients were treated with IVIG 10% every 3 (n = 21) or 4 weeks (n = 30) at a dose of 200–800 mg/kg for 12 months. Total immunoglobulin G (IgG) and subclass concentrations approximately doubled from pre- to 15 min post-infusion. The maximum concentration of total IgG (mean ± SD) was 21.82 ± 5.83 g/L in patients treated 3-weekly and 17.42 ± 3.34 g/L in patients treated 4-weekly. Median trough IgG concentrations were nearly constant over the course of the study, remaining between 11.0 and 12.2 g/L for patients on the 3-week schedule and between 8.10 and 8.65 g/L for patients on the 4-week schedule. The median terminal half-life of total IgG was 36.1 (range 18.5–65.9) days, with generally similar values for the IgG subclasses (26.7–38.0 days). Median half-lives for specific antibodies ranged between 21.3 and 51.2 days for anti-cytomegalovirus, anti-Haemophilus influenzae, anti-measles, anti-tetanus toxoid, anti-varicella zoster virus antibodies, and anti-Streptococcus pneumoniae subtype antibodies. Overall, IVIG 10% demonstrated pharmacokinetic properties similar to those of other commercial IVIG 10% preparations and 3- or 4-weekly administration achieved sufficient concentrations of IgG, IgG subclasses, and specific antibodies, exceeding the recommended level needed to effectively prevent serious bacterial infections.

Seroprevalence and Risk Factors of Varicella Zoster Infection in Iranian Adolescents: A Multilevel Analysis; The CASPIAN-III Study.

The objective of this study was to evaluate the varicella zoster virus (VZV) immunity in Iranian adolescents. It was conducted as a primary study for vaccine implementation, and to investigate the association of climatic and socioeconomic factors with the epidemiology of this infection. In this cross- sectional study, anti VZV antibodies were measured in serum samples obtained in a national school-based health survey (CASPIAN- III). Association of demographic, socio-economic, and climate of the living region with the frequency of VZV was investigated by multivariate multilevel analysis. Overall, sera of 2753 individuals aged 10–18 were tested for VZV antibodies, from those 87.4% were positive. The prevalence was statistically different in four socio-geographic regions (P<0.001), varying between 85.24% in West region (mostly mountainous areas with cold climate) to 94.59% in Southeast region (subtropical climate). Among variables studied, only age and mean daily temperature of the living area were positively associated with the VZV seroprevalence. Our findings show that most Iranians develop immunity to VZV before the age of 10, but a substantial proportion of them are yet susceptible to the infection. Therefore, it seems that the best strategy to reduce the burden of the disease is to vaccinate high- risk adults, i.e. those without a history of varicella infection. The regional temperature might be the only determinant of VZV epidemiology in Iran.

Seroprevalence of Anti-hepatitis B Virus, Anti-hepatitis A Virus, and Anti-varicella Zoster Virus Antibodies in Nursing Students from 2009 to 2013

Background: Nursing students may be exposed to patients with infectious diseases such as hepatitis B and hepatitis A through needle stick injuries or close contact during their clinical practice. This study surveyed the presence of anti‐ hepatitis B virus (anti-HBV), anti‐hepatitis A virus (anti‐HAV), and anti-varicella zoster virus antibodies in nursing students before the initiation of their clinical practice to help prevent subsequent infections. Methods: From 2009 to 2013, the junior students of a nursing college in Jeollabuk-do were tested for antibodies against the hepatitis B, hepatitis A, and varicella zoster viruses before the initiation of their clinical practice. Results: The students tested positive for anti‐HBV (46.2-57.1%), anti‐HAV (0-10.5%), and anti-varicella zoster antibodies (80.2-90.2%). No significant differences in the positivity rates were observed with respect to the year of their enrollment. Conclusion: This study was a survey of the seroprevalence of anti-HBV, anti-HAV, and anti-varicella zoster antibodies in nursing students before they started their clinical practice. The positivity rate of anti‐HAV was lower than 10%. In order to prevent infection, it is necessary to test nursing students for the presence of antibodies against hepatitis B, hepatitis A, varicella, measles, mumps, and rubella, and check their vaccination history as recommended in the adult immunization schedule. Vaccination must be recommended for students who test negative for the respective antibodies.

Nosocomial transmission of varicella to a healthcare provider positive for anti-varicella zoster virus antibodies: nonprotective positivity with an immune adherence hemagglutination assay

A 24-year-old male healthcare provider, having attended a varicella patient 2weeks before, developed varicella himself. He had shown a positive result for anti-VZV antibodies measured with an immune adherence hemagglutination assay (1:4) 1year before. The present case shows that a positive result with this assay does not necessarily indicate protection against VZV infection.

Chronic Herpes Simplex Scleritis: Characterization of 9 Cases of an Underrecognized Clinical Entity

To characterize in detail persistent and recalcitrant infectious scleritis resulting from herpes simplex virus (HSV). Retrospective and interventional clinical and immunopathologic case series. Nine patients with chronic scleral redness, edema, and pain refractory to conventional therapy underwent a scleroconjunctival biopsy for routine histopathologic evaluation and definitive immunodiagnosis for the presence of HSV. Immunofluorescent probing for HSV was performed on the patient specimens. Negative controls for HSV included elimination of anti-HSV and anti-varicella zoster virus antibody in the probing process and the use of normal human conjunctiva and sclera as substrates. Response to therapy with acyclovir was monitored and recorded. The average age of the affected patients was 50.2 years, and the average duration of symptoms before tissue diagnosis of herpetic scleritis was 3.2 years (median, 4 years). Three histopathologic patterns were discovered: granulomatous inflammation (2 cases), plasma cell-rich pyogenic granuloma-like pattern (1 case), and reactive fibroinflammatory pattern (6 cases). Herpes antigen was demonstrated uniformly by immunofluorescence in a perivascular distribution and less commonly in the interstitium. Varicella zoster virus was not detected, and all controls for nonspecific antibody reagent binding to tissue showed negative results. Acyclovir caused a dramatic improvement in the chronic or recurrent ocular inflammation in all instances, with an average duration of improvement of inflammation of 15.3 months. Unrecognized HSV infection can cause longstanding scleritis. Histopathologic features of HSV scleritis are varied and nonspecific; immunofluorescent demonstration of HSV protein can make a definitive diagnosis. Prolonged administration of acyclovir is required for effective therapy.

ASEPTIC MENINGITIS AS A RARE MANIFESTATION OF SAPHO SYNDROME

Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome is characterized by multifocal aseptic osteomyelitis of an uncertain etiology. In 1987, it was first proposed as a unifying concept to describe the association between musculoskeletal disorders and various dermatologic conditions.1 Recently, we encountered a patient with SAPHO syndrome who exhibited aseptic meningitis and lower cranial nerve palsies. ### Case report. A 52-year-old woman was admitted to our hospital because of severe headache and a mild fever of 37.5°C. Her past and family histories were unremarkable; however, 2 months before admission, she felt some precordial pain and noticed eruptions on her palms and soles of her feet. On admission, her general condition was unremarkable. There were no palpable lymph nodes, though there were a few pustular eruptions on her palms and soles. On neurologic examination, she had no neurologic deficits except for mild neck stiffness. Brain CT and MRI results were normal. Her CSF showed a mild pleocytosis (101/mm3, 98% lymphocytes, 2% polymorphs), and slightly high protein (52 mg/dL) and normal glucose (58 mg/dL) levels. CSF culture was negative. PCR tests for herpes simplex virus and anti-varicella zoster virus antibody in the CSF were also negative. She was diagnosed with …

Ramsay Hunt Syndrome in a 3‐Month‐Old Infant

Ramsay Hunt syndrome is a disorder characterized by herpetic eruptions on the auricle, facial paralysis, and vestibulocochlear dysfunction, and is attributed to varicella zoster virus infection in the geniculate ganglion. Although it is a common cause of acute peripheral facial paralysis, children are not usually affected. We describe Ramsay Hunt syndrome in a 3-month-old infant who was referred because of a 2-day-old appearance of herpetic blisters on the right auricle and along the distribution of the right facial nerve. His mother had been infected with chickenpox during the second trimester of pregnancy. The infant presented with right facial palsy and was anxious, but had no fever. Otoscopy revealed herpetic eruptions in the right ear canal. Otoacoustic emissions were absent in the right ear and auditory brainstem responses confirmed moderate sensorineural hearing loss. Appropriate treatment resulted in slight improvement after the first week and complete recovery within 4 months. Infection with varicella zoster virus was proved by a significant increase in the serum anti-varicella zoster virus antibody titer during the convalescent phase of the disease.

Varicella Zoster Virus Infection in Pregnancy

ABSTRACTVaricella and herpes zoster during pregnancy has been associated with birth defects, neonatal varicella, herpes zoster in newborns and infants. The aim of the present study was to determine the consequences for the neonates, whose mothers were closely exposed to varicella zoster virus (VZV) during pregnancy. Fifty six pregnant women with uncertain histories of prior VZV infection, after a close exposure to varicella, were enrolled for examination of specific anti VZV antibodies. CFT and ELISA were performed. Eleven (20%) pregnancies were complicated with varicella and 4 (7%) with herpes zoster. Intrauterine varicella infection was identified on the basis of clinical evidences (anomalies characteristic for the congenital varicella syndrome, acute varicella at birth or herpes zoster in infancy) by history of delivery. Four infants with neonatal varicella and their mothers were examined serologically. After a close exposure to varicella, seronegative by CFT were 19 (34%) pregnant women and 9 (16%) by ELISA. Birth defects or herpes zoster in infancy were not found. None of the 4 infants whose mothers had herpes zoster were with physical anomalies. One infant whose mother was with first trimester varicella showed intrauterine retardation. Three babies with neonatal varicella were born by mothers with third trimester varicella and low levels of antibodies to VZV. One infant whose mother lacked antibody to VZV died of neonatal varicella. Varicella during pregnancy was associated with fetal or neonatal infections and diseases, but herpes zoster wasn't.

Delayed facial paralysis after vestibular schwannoma surgery: role of herpes viruses reactivation--our experience in eight cases.

The objectives of this study were to study the role of herpes virus reactivation in the onset of delayed facial paralysis (DFP) occurring more than 72 hours after vestibular schwannoma (VS) surgery and to advocate specific medical management. We conducted a retrospective case review. University-based, tertiary care center. Eight patients managed for DFP in a series of 348 patients operated for a VS. Patients were evaluated and graded according to the House and Brackmann grading system and followed up for 1 year. A serologic search for specific antiherpes simplex viruses type 1 and 2 (HSV-2) and varicella zoster virus (VZV) antibodies at the onset of DFP and 2 weeks later was possible in three cases. Seven of the eight patients were given intravenous acyclovir (30 mg/kg/ for 5 days) and methylprednisolone (2 mg.kg/ for 7 days). Mean delay of DFP onset was 8.75 days. All treated patients had a House and Brackmann Grade 1 recovery: mean time to recovery was 40.4 days. The last one had only a Grade 3 recovery because he could not be treated because of postoperative transient psychiatric problems. Serologic testing in those patients in whom it could be done revealed either a high level of anti HSV or VZV antibodies at the time of onset or a dramatic increase in anti-HSV or anti-VZV antibodies between the two samples, strongly suggesting an HSV or VZV reactivation. HSV or VZV reactivation might be responsible for most cases of DFPs, thus suggesting the usefulness of immediate steroid and acyclovir administration to obtain total recovery. The viral reactivation mechanism is comparable to that already suspected in DFP occurring with the same delay in middle ear surgical procedures.

Varicella vaccination in pediatric kidney transplant candidates.

Existing studies support the use of varicella vaccine in a two-dose regimen in patients with renal disease prior to transplantation. Levels of anti-varicella zoster virus antibody should be monitored on a regular basis after immunization, and where a loss of a previously protective antibody titer occurs, a third booster dose should be considered pretransplant. Further data need to be collected regarding the use of the vaccine in seronegative patients who have already undergone transplantation.

Cytomegalovirus and other herpesviruses infections in heart and bone marrow transplant recipients

From January 1988 to January 1989 all the heart transplant and bone marrow recipients at the Instituto do Coração of the Hospital das Clínicas of the University of São Paulo Medical School were studied for the incidence and morbidity associated with herpesviruses infections after transplantation. Five bone marrow and 5 heart transplant recipients were followed for a mean of 4.2 months post-transplantation. All the patients were seropositive for cytomegalovirus (CMV) before admission and 80% experienced one or more recurrences during the observation period. Of the 12 episodes of CMV infection, that were identified in this study, 83% were accompanied by clinical or laboratory abnormalities. However, there was only one case of severe disease. The overall incidence of infection for herpes simplex (HSV) was 50%. Although most of HSV reactivations were oral or genital, one case of HSV hepatitis occurred. One of the 6 episodes of HSV infections that were treated with acyclovir showed an unsatisfactory response and was successfully managed with ganciclovir. All the individuals had anti-varicella zoster virus antibodies, but none of them developed infection. The study emphasizes the importance of active diagnostic surveillance of herpesvirus infections in transplant patients. Both CMV and HSV reactivations showed high incidence and important morbidity and thus, deserve prophylactic therapy.

Two Cases of Peripheral Facial Paralysis Associated with Varicella

Facial paralysis caused by chickinpox are rare. Two cases of facial paralysis associated with varicella were described.First case, a 5-year-old girl, complained of immobility of right facial muscle on Feb. 6, 1979. Three days later, she developed typical varicella. Laboratory studies revealed no abnormalities except for an elevated anti varicella-zoster virus (VZV) antibody levels in the serum. Anti VZV antibody titers were measured by immune adherence hemagglutination test (IAHA). The serum IAHA titers for VZV were 1:128 (Feb. 14) and 1:128 (March 5). Complete recovery occured five weeks after the onset.Second case, a 5-year-old boy, had a skin rash and diagnosed as varicella on April 5, 1979. On May 17, he noticed a weakness of the right facial muscle. No other neurological abnormalities were observed. About two weeks later, mumps occured. The serum IAHA titers for VZV were 1:64 (May 23) and 1:128 (June 18) and the mumps virus antibody titers were 1:<2 (May 23) and 1:64 (June 18). The facial palsy completely recovered after six weeks.