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Test Catalog

Test ID: VZM    
Varicella-Zoster Virus (VZV) Antibody, IgM, Serum

Useful For Suggests clinical disorders or settings where the test may be helpful

Diagnosing acute-phase infection with varicella-zoster virus

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 exanthematous (rash-associated) diseases, chickenpox and herpes zoster (shingles). Chickenpox is a highly contagious disease usually contracted during childhood and is characterized by a dermal vesiculopustular rash that develops in successive crops approximately 10 to 21 days following exposure.(1). Although primary infection results in immunity to subsequent exposure to chickenpox, the virus remains latent in the body, localized to the dorsal root or cranial nerve ganglia. Reactivation of latent infection manifests as herpes zoster. On reactivation, the virus migrates along neural pathways to the skin, producing a unilateral rash usually limited to a single dermatome. Reactivation occurs in older adults and in patients with impaired cellular immunity.(2)

 

Several populations are at risk of suffering unusually severe reactions to VZV infections. The infection in pregnant women may spread through the placenta to the fetus causing congenital disease in the infant. Immunocompromised patients in hospitals may contract severe nosocomial infections from others who have active VZV infections are at risk for developing severe VZV-related complications, which include cutaneous disseminated disease and visceral organ involvement.(2,3). Therefore, serologic screening of direct health care providers (physicians, allied health care personnel) and individuals in high-risk groups is necessary to avoid uncontrolled spread of infection.

 

While the clinical presentation of VZV infection is generally characteristic, serologic evaluation of patients with atypical and systemic infections is often required. For example, it is extremely important to serologically evaluate patients for the early detection of VZV infections in hospital settings. Nosocomial spread of VZV infection can be life-threatening to immunocompromised patients susceptible to infection.

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.

Negative

Reference values apply to all ages.

Interpretation Provides information to assist in interpretation of the test results

A positive IgM result indicates a recent infection with varicella-zoster virus (VZV).

 

A negative result does not rule out the diagnosis of VZV infection. The specimen may have been drawn before the appearance of detectable antibodies. Negative results in suspected early VZV infection should be followed by testing a new specimen in 2 to 3 weeks.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

The performance characteristics with individuals vaccinated with varicella-zoster virus (OKA strain) have not been established.

 

The test must be performed on serum. The use of whole blood, plasma, or cord blood has not been established.

 

Positive results from cord blood or neonates should be interpreted with caution.

 

Results from immunocompromised patients should be interpreted with caution.

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: Herpes Zoster. N Engl J Med. 2002;347:340-346

3. Cvjetkovic D, Jovanovic J, Hrnjakovic-Cvjetkovic I, et al: Reactivation of herpes zoster infection by varicella-zoster virus. Med Pregl. 1999;52(3):125-128

4. Flamholc L: Neurological complications in herpes zoster. Scand J Infect Dis. 1996;100:35-40

5. 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