Antigen detection: the method of choice in comparison with virus isolation and serology for laboratory diagnosis of herpes zoster in human immunodeficiency virus-infected patients.

Journal of Clinical Microbiology
H DahlA Linde

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 treatm...Continue Reading

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Citations

Dec 5, 2006·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Robert H DworkinRichard J Whitley
Jan 1, 2013·Pathogens·Kristen Haberthur, Ilhem Messaoudi
Oct 3, 2002·Anesthesiology·Russell K McAllisterTimothy M Bittenbinder
Jan 5, 2002·Journal of Perinatology : Official Journal of the California Perinatal Association·A Sauerbrei, P Wutzler
Jun 23, 2006·Reviews in Medical Virology·Mark Quinlivan, Judith Breuer
Jun 14, 2005·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·G S AthwalA J Weiland
Aug 2, 2002·The New England Journal of Medicine·John W Gnann, Richard J Whitley
Oct 12, 2013·Postgraduate Medicine·Mazen S Bader
Jan 12, 2019·BMJ : British Medical Journal·Phuc Le, Michael Rothberg
Jun 27, 2003·Primary Care·Peter T Frame

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