Test Id : VZPG
Varicella-Zoster Antibody, IgG, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
Determination of immune status of individuals to the varicella-zoster virus (VZV)
Documentation of previous infection with VZV in an individual without a previous record of immunization to VZV
Method Name
A short description of the method used to perform the test
Multiplex Flow Immunoassay
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Chickenpox
Herpes Zoster Antibodies
Shingles
Varicella-Zoster Antibody Screen, Qualitative, Serum
Varicella-Zoster Immune Status, Serum
VZ Ab, IgG
VZV
Varicella-Zoster IgG, Serum
Specimen Type
Describes the specimen type validated for testing
Serum
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-General Request (T239)
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
0.4 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
| Heat-inactivated specimen | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Frozen | 14 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Determination of immune status of individuals to the varicella-zoster virus (VZV)
Documentation of previous infection with VZV in an individual without a previous record of immunization to VZV
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Varicella-zoster virus (VZV), a herpes virus, causes 2 distinct exanthematous (rash-associated) diseases: chickenpox (varicella) and herpes zoster (shingles). Chickenpox is a highly contagious, though typically benign, disease, usually contracted during childhood. Chickenpox is characterized by a dermal vesiculopustular rash that develops in successive crops approximately 10 to 21 days following exposure.(1) Although primary infection with VZV results in immunity and protection from subsequent infection, VZV remains latent within sensory dorsal root ganglia and upon reactivation, manifests as herpes zoster or shingles. During reactivation, the virus migrates along neural pathways to the skin, producing a unilateral rash, usually limited to a single dermatome. Shingles is an extremely painful condition typically occurring in older nonimmune adults or those with waning immunity to VZV and in patients with impaired cellular immunity.(2)
Individuals at risk for severe complications following primary VZV infection include women who are pregnant, in whom the virus may spread through the placenta to the fetus, causing congenital disease in the infant. Additionally, immunosuppressed patients are at risk for developing severe VZV-related complications, which include cutaneous disseminated disease and visceral organ involvement.(2,3)
Serologic screening for IgG-class antibodies to VZV aids in identifying nonimmune individuals.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Vaccinated: Positive (> or =1.1 antibody index [AI])
Unvaccinated: Negative (< or =0.8 AI)
Reference values apply to all ages.
Interpretation
Provides information to assist in interpretation of the test results
The reported antibody index (AI) value is for reference only. This is a qualitative test, and the numeric value of the AI is not indicative of the amount of antibody present. AI values above the manufacturer recommended cutoff for this assay indicate that specific antibodies were detected, suggesting prior exposure or vaccination.
Positive: AI value of 1.1 or higher:
The presence of detectable IgG-class antibodies indicates prior exposure to the varicella-zoster virus (VZV) through infection or immunization. Individuals testing positive are considered immune to varicella-zoster.
Equivocal: AI 0.9-1.0
Submit an additional specimen for testing in 10 to 14 days to demonstrate IgG seroconversion if recently vaccinated or if otherwise clinically indicated.
Negative: AI of 0.8 or lower
The absence of detectable IgG-class antibodies suggests no prior exposure to the VZV or the lack of a specific immune response to immunization.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Immunoglobulin G-class antibodies to varicella-zoster virus may be present in serum specimens from individuals who have received blood products within the past several months but have not been immunized or experienced past infection with this virus.
Serum specimens drawn early during acute phase of infection may be negative for IgG-class antibodies to this virus.
Supportive Data
To evaluate the accuracy of the BioPlex Varicella-Zoster Virus (VZV) IgG multiplex flow immunoassay, 500 prospective serum samples were analyzed in a blinded fashion by the Diamedix VZV IgG enzyme immunoassay (EIA) (Diamedix) and the BioPlex VZV IgG assay. Samples with discordant results after initial testing were repeated by both assays during the same freeze/thaw cycle. Further discrepancies were evaluated by the SeraQuest VZV IgG EIA.(Quest International) The results are summarized in the Table below:
Table. Comparison between Bioplex and Diamedix Varicella-Zoster Virus (VZV) Assays
| Diamedix VZV IgG EIA | ||||
| BioPlex VZV IgG | | Positive | Negative | Equivocal |
| Positive | 436 | 0 | 0 | |
| Negative | 18(a) | 22 | 4 | |
| Equivocal | 19 | 0 | 1 | |
a. All 18 specimens tested positive by the SeraQuest VZV IgG EIA.
Sensitivity: 92.2% (436/473); 95% CI: 89.4%-94.3%
Specificity: 100.0 (22/22); 95% CI: 82.5%-100.0%
Overall percent agreement: 91.8% (459/500); 95% CI: 89.0%-93.9%
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Yankowitz J, Grose C. Congenital infections. In: Storch GA, ed. Essentials of diagnostic virology. Churchill Livingstone; 2000:187-201
2. Gnann JW, Whitley RJ. Clinical practice. Herpes zoster. N Engl J Med. 2002;347(5):340-346
3. Cvjetkovic D, Jovanovic J, Hrnjakovic-Cvjetkovic I, Brkic S, Bogdanovic M. Reaktivacija herpes zoster infekcije varicela-zoster virusom [Reactivation of herpes zoster infection by varicella-zoster virus]. Med Pregl. 1999;52(3-5):125-128
4. Whitely RJ. Chickenpox and Herpes Zoster (Varicella-Zoster virus). In Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020: 1849-1856
Method Description
Describes how the test is performed and provides a method-specific reference
The BioPlex 2200 Varicella-Zoster Virus (VZV) IgG assay uses multiplex flow immunoassay technology. Briefly, serum samples are mixed and incubated at 37 degrees C with sample diluent and dyed beads coated with VZV antigen. After a wash cycle, antihuman IgG-antibody conjugated to phycoerythrin (PE) is added to the mixture and incubated at 37 degrees C. Excess conjugate is removed in another wash cycle, and the beads are resuspended in wash buffer. The bead mixture then passes through a detector that identifies the bead based on dye fluorescence and determines the amount of antibody captured by the antigen based on the fluorescence of the attached PE. Raw data is calculated in relative fluorescence intensity.
Three additional dyed beads, an internal standard bead, a serum verification bead, and a reagent blank bead are present in each reaction mixture to verify detector response, the addition of serum to the reaction vessel and the absence of significant nonspecific binding in serum.(Package insert: BioPlex 2200 System MMRV IgG, Bio-Rad Laboratories; 02/2019)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Friday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
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Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
86787
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| VZPG | Varicella-Zoster Ab, IgG, S | 15410-4 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| VZG | Varicella-Zoster Ab, IgG, S | 15410-4 |
| DEXG4 | Varicella IgG Antibody Index | 5403-1 |