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Serum Antibody Levels as Risk Factors in the Dissemination of Herpes Zoster
Mark H. Mazur, MD;
Richard J. Whitley, MD;
Raphael Dolin, MD
Arch Intern Med. 1979;139(12):1341-1345.
Abstract
Serum antibody levels against varicella-zoster virus (VZV) were examined by immune adherence hemagglutination assay (IAHA), indirect fluorescent antibody (IFA) assay, and complement fixation techniques in 67 immunocompromised patients with localized and disseminated herpes zoster. In the serum obtained initially, undetectable IAHA titers were found in 56.5% of the patients with disseminated zoster compared with 18.2% of those with localized zoster. When serum obtained within the first seven days of illness was analyzed, undetectable IAHA titers and IFA titers of < 32 were noted in 77.8% of those with disseminated zoster but in only 18.5% of those with localized disease. Peak serum antibody titers in patients with disseminated zoster were eventually equal to or greater than those in localized zoster. The patient groups were comparable in age, underlying disease, and therapy, although Hodgkin's disease was more frequent in patients with disseminated zoster. Thus, the absent IAHA or low IFA levels of circulating antibody early in illness were highly significant risk factors in dissemination of virus in herpes zoster.
(Arch Intern Med 139:1341-1345, 1979)
Author Affiliations
From the Laboratory of Clinical Investigation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md (Drs Mazur and Dolin); and the Department of Pediatrics, University of Alabama Medical Center at Birmingham (Dr Whitley). Dr Mazur is in private practice. Dr Dolin is now with the University of Vermont, Burlington.
Footnotes
Accepted for publication March 12, 1979.
Reprint requests to National Institutes of Health, Bldg 10, Room 11N-214, Bethesda, MD 20014 (Dr Mazur).
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