Abstract
Ninety-two adult human immunodeficiency virus (HIV)-infected patients with suspected herpes zoster were included in a study. The clinical diagnosis of herpes zoster was verified by examination of blister cell and fluid material or serum samples. Antigen detection by a direct immunofluorescence assay with a fluorescein isothiocyanate-labelled monoclonal antibody, virus isolation, and serologic methods (in-house varicella-zoster virus [VZV] immunoglobulin G [IgG] and IgM enzyme-linked immunosorbent assays and the commercial Enzygnost assay) were compared. The direct immunofluorescence assay was found to be the most sensitive method, diagnosing 85 of 92 infections (92%), while the sensitivity of virus isolation was 65% (60 of 92 patients). Despite the use of two different serological methods, only 60 of 92 patients (65%) had significant VZV IgG titer rises, and only 26 of 92 patients (28%) had detectable VZV IgM. The lack of a VZV IgG antibody titer rise was found to correlate with low CD4 counts in peripheral blood and high VZV IgG titers in the acute-phase serum sample. The frequency of IgM-positive sera was lower than that expected from reports of studies with patients without AIDS. This may be related to early antiviral treatment or deficient antibody production due to the HIV-related immunosuppression. There was no significant difference in CD4 counts between VZV IgM-positive and -negative patients.
Full Text
The Full Text of this article is available as a PDF (165.7 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Andrei G., Snoeck R., Reymen D., Liesnard C., Goubau P., Desmyter J., De Clercq E. Comparative activity of selected antiviral compounds against clinical isolates of varicella-zoster virus. Eur J Clin Microbiol Infect Dis. 1995 Apr;14(4):318–329. doi: 10.1007/BF02116525. [DOI] [PubMed] [Google Scholar]
- Brinker J. P., Doern G. V. Comparison of MRC-5 and A-549 cells in conventional culture tubes and shell vial assays for the detection of varicella-zoster virus. Diagn Microbiol Infect Dis. 1993 Jul;17(1):75–77. doi: 10.1016/0732-8893(93)90075-i. [DOI] [PubMed] [Google Scholar]
- Burdge D. R., Voigt R., Lindley J. I., Gage L., Sacks S. L. Sorivudine (BV-ara-U) for the treatment of complicated refractory varicella zoster virus infection in HIV-infected patients. AIDS. 1995 Jul;9(7):810–812. doi: 10.1097/00002030-199507000-00021. [DOI] [PubMed] [Google Scholar]
- Esmann V., Geil J. P., Kroon S., Fogh H., Peterslund N. A., Petersen C. S., Ronne-Rasmussen J. O., Danielsen L. Prednisolone does not prevent post-herpetic neuralgia. Lancet. 1987 Jul 18;2(8551):126–129. doi: 10.1016/s0140-6736(87)92331-2. [DOI] [PubMed] [Google Scholar]
- Manian F. A. A prospective study of daily measurement of C-reactive protein in serum of adults with neutropenia. Clin Infect Dis. 1995 Jul;21(1):114–121. doi: 10.1093/clinids/21.1.114. [DOI] [PubMed] [Google Scholar]
- Pérez J. L., García A., Niubò J., Salvà J., Podzamczer D., Martín R. Comparison of techniques and evaluation of three commercial monoclonal antibodies for laboratory diagnosis of varicella-zoster virus in mucocutaneous specimens. J Clin Microbiol. 1994 Jun;32(6):1610–1613. doi: 10.1128/jcm.32.6.1610-1613.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rawlinson W. D., Dwyer D. E., Gibbons V. L., Cunningham A. L. Rapid diagnosis of varicella-zoster virus infection with a monoclonal antibody based direct immunofluorescence technique. J Virol Methods. 1989 Jan;23(1):13–18. doi: 10.1016/0166-0934(89)90084-0. [DOI] [PubMed] [Google Scholar]
- Schirm J., Meulenberg J. J., Pastoor G. W., van Voorst Vader P. C., Schröder F. P. Rapid detection of varicella-zoster virus in clinical specimens using monoclonal antibodies on shell vials and smears. J Med Virol. 1989 May;28(1):1–6. doi: 10.1002/jmv.1890280102. [DOI] [PubMed] [Google Scholar]
- Sundqvist V. A. Frequency and specificity of varicella zoster virus IgM response. J Virol Methods. 1982 Nov;5(3-4):219–227. doi: 10.1016/0166-0934(82)90012-x. [DOI] [PubMed] [Google Scholar]
- Watson P. N., Evans R. J. Postherpetic neuralgia. A review. Arch Neurol. 1986 Aug;43(8):836–840. doi: 10.1001/archneur.1986.00520080074027. [DOI] [PubMed] [Google Scholar]