Varicella-zoster virus immunity in dermatological patients on systemic immunosuppressant treatment.

Hdl Handle:
http://hdl.handle.net/10147/207664
Title:
Varicella-zoster virus immunity in dermatological patients on systemic immunosuppressant treatment.
Authors:
Hackett, C B; Wall, D; Fitzgerald, S F; Rogers, S; Kirby, B
Affiliation:
Department of Dermatology, St Vincent's University Hospital, Elm Park, Dublin 4, , Ireland. c.hackett@svuh.ie
Citation:
Br J Dermatol. 2011 Jun;164(6):1387-9. doi: 10.1111/j.1365-2133.2011.10315.x.
Journal:
The British journal of dermatology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207664
DOI:
10.1111/j.1365-2133.2011.10315.x
PubMed ID:
21410679
Abstract:
BACKGROUND: Primary varicella infection is caused by varicella-zoster virus (VZV). It is a common childhood infection, which is usually benign but can occasionally cause morbidity and mortality. In immunosuppressed adults, atypical presentation and disseminated disease can occur with significant morbidity and mortality. A VZV vaccine is available. OBJECTIVES: This study was designed to measure the prevalence of immunity to VZV and to determine the predictive value of a self-reported history of varicella infection in a population of dermatological patients receiving systemic immunosuppressant therapy. We sought to assess the need for routine serological testing for varicella-zoster immunity in this cohort. METHODS: Serological testing for VZV immunity was done on 228 patients receiving systemic immunosuppressive treatment for a dermatological condition. Information regarding a history of previous primary VZV infection was obtained from each patient. RESULTS: Two hundred and twenty-eight patients had VZV serology performed. The mean age of the patients was 49.6 years. The prevalence of VZV seropositivity in this cohort was 98.7%. One hundred and two patients (44.7%) reported having a definite history of primary VZV. The sensitivity of a self-reported history of VZV infection was 45.3% with a specificity of 100%. The positive and negative predictive values of a self-reported history of VZV for serologically confirmed immunity were 100% and 2.3%, respectively. CONCLUSIONS: The prevalence of VZV IgG antibodies in our cohort of Irish dermatology patients receiving immunosuppressive therapy is 98.7%. A recalled history of varicella infection is a good predictor of serological immunity. This study has shown that there are VZV-susceptible individuals within our cohort. These patients did not have a clear history of previous infection. We recommend serological testing of patients without a clear history of infection prior to the commencement of immunosuppressive therapy and vaccination of patients with negative serology.
Language:
eng
MeSH:
Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Viral/blood; Chickenpox/*immunology; Female; Herpesvirus 3, Human/*immunology; Humans; Immunity, Active/*immunology; Immunoglobulin G/blood; Immunosuppressive Agents/*therapeutic use; Male; Middle Aged; Skin Diseases/*drug therapy/immunology; Young Adult
ISSN:
1365-2133 (Electronic); 0007-0963 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorHackett, C Ben_GB
dc.contributor.authorWall, Den_GB
dc.contributor.authorFitzgerald, S Fen_GB
dc.contributor.authorRogers, Sen_GB
dc.contributor.authorKirby, Ben_GB
dc.date.accessioned2012-02-01T10:34:21Z-
dc.date.available2012-02-01T10:34:21Z-
dc.date.issued2012-02-01T10:34:21Z-
dc.identifier.citationBr J Dermatol. 2011 Jun;164(6):1387-9. doi: 10.1111/j.1365-2133.2011.10315.x.en_GB
dc.identifier.issn1365-2133 (Electronic)en_GB
dc.identifier.issn0007-0963 (Linking)en_GB
dc.identifier.pmid21410679en_GB
dc.identifier.doi10.1111/j.1365-2133.2011.10315.xen_GB
dc.identifier.urihttp://hdl.handle.net/10147/207664-
dc.description.abstractBACKGROUND: Primary varicella infection is caused by varicella-zoster virus (VZV). It is a common childhood infection, which is usually benign but can occasionally cause morbidity and mortality. In immunosuppressed adults, atypical presentation and disseminated disease can occur with significant morbidity and mortality. A VZV vaccine is available. OBJECTIVES: This study was designed to measure the prevalence of immunity to VZV and to determine the predictive value of a self-reported history of varicella infection in a population of dermatological patients receiving systemic immunosuppressant therapy. We sought to assess the need for routine serological testing for varicella-zoster immunity in this cohort. METHODS: Serological testing for VZV immunity was done on 228 patients receiving systemic immunosuppressive treatment for a dermatological condition. Information regarding a history of previous primary VZV infection was obtained from each patient. RESULTS: Two hundred and twenty-eight patients had VZV serology performed. The mean age of the patients was 49.6 years. The prevalence of VZV seropositivity in this cohort was 98.7%. One hundred and two patients (44.7%) reported having a definite history of primary VZV. The sensitivity of a self-reported history of VZV infection was 45.3% with a specificity of 100%. The positive and negative predictive values of a self-reported history of VZV for serologically confirmed immunity were 100% and 2.3%, respectively. CONCLUSIONS: The prevalence of VZV IgG antibodies in our cohort of Irish dermatology patients receiving immunosuppressive therapy is 98.7%. A recalled history of varicella infection is a good predictor of serological immunity. This study has shown that there are VZV-susceptible individuals within our cohort. These patients did not have a clear history of previous infection. We recommend serological testing of patients without a clear history of infection prior to the commencement of immunosuppressive therapy and vaccination of patients with negative serology.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshAntibodies, Viral/blooden_GB
dc.subject.meshChickenpox/*immunologyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHerpesvirus 3, Human/*immunologyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshImmunity, Active/*immunologyen_GB
dc.subject.meshImmunoglobulin G/blooden_GB
dc.subject.meshImmunosuppressive Agents/*therapeutic useen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshSkin Diseases/*drug therapy/immunologyen_GB
dc.subject.meshYoung Adulten_GB
dc.titleVaricella-zoster virus immunity in dermatological patients on systemic immunosuppressant treatment.en_GB
dc.contributor.departmentDepartment of Dermatology, St Vincent's University Hospital, Elm Park, Dublin 4, , Ireland. c.hackett@svuh.ieen_GB
dc.identifier.journalThe British journal of dermatologyen_GB
dc.description.provinceLeinster-
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