From the Guidelines
The presence of VZV antibodies with IgM at 1.76 and IgG at 2.66 indicates a recent or active varicella-zoster virus infection, suggesting either chickenpox or shingles, and warrants consideration of antiviral treatment and isolation to prevent transmission. The elevated IgM antibodies suggest an acute infection, as IgM is typically the first antibody produced in response to infection and usually decreases within a few weeks 1. The presence of IgG antibodies indicates that your immune system has developed a longer-term response to the virus. This pattern is consistent with either chickenpox (primary VZV infection) or shingles (reactivation of latent VZV).
Key Considerations
- No specific medication is required if symptoms are mild, but for moderate to severe cases, antiviral medications like acyclovir (800 mg five times daily for 7-10 days), valacyclovir (1000 mg three times daily for 7 days), or famciclovir (500 mg three times daily for 7 days) may be prescribed, as supported by the Advisory Committee on Immunization Practices (ACIP) recommendations 1.
- These medications are most effective when started within 72 hours of rash onset.
- You should avoid contact with pregnant women, newborns, and immunocompromised individuals until lesions crust over, as the virus spreads through direct contact with fluid from blisters or through respiratory droplets, so isolation is important to prevent transmission 1.
Prevention and Treatment
- Vaccination is a key component of varicella prevention, and the ACIP recommends varicella vaccination for all children and adults without evidence of immunity 1.
- For individuals who have already been infected, antiviral treatment and isolation are crucial to prevent transmission and manage symptoms.
- The use of VariZIG (varicella zoster immune globulin) may be considered for certain high-risk individuals, such as immunocompromised persons, but its effectiveness and duration of protection are unknown 1.
From the Research
Interpretation of VZV Antibody Results
- The presence of VZV antibodies, including IgM and IgG, indicates an immune response to Varicella-zoster virus [(2,3)].
- IgM antibodies are typically associated with a recent or acute infection, while IgG antibodies are indicative of a past infection or immunity [(3,4)].
- The given values of 1.76 for IgM and 2.66 for IgG suggest that the individual has been exposed to VZV and has developed an immune response 3.
- However, without more information about the testing methodology and reference ranges, it is difficult to determine the exact significance of these values 4.
Possible Scenarios
- The individual may have had a recent VZV infection, as indicated by the presence of IgM antibodies 3.
- The individual may have been vaccinated against VZV or have had a past infection, as indicated by the presence of IgG antibodies [(2,5)].
- The individual may be at risk for VZV reactivation, particularly if they are immunocompromised or elderly [(6,5)].
Laboratory Diagnosis and Antiviral Therapy
- Laboratory confirmation of VZV infection can be accomplished through detection of viral proteins or DNA [(2,6)].
- Antiviral therapy, such as acyclovir, valacyclovir, and famciclovir, is available for the treatment of VZV infections [(2,6,5)].