Varicella-zoster virus immunity in dermatological patients on systemic immunosuppressant treatment.
Affiliation
Department of Dermatology, St Vincent's University Hospital, Elm Park, Dublin 4, , Ireland. c.hackett@svuh.ieIssue Date
2012-02-01T10:34:21ZMeSH
AdolescentAdult
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
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Br J Dermatol. 2011 Jun;164(6):1387-9. doi: 10.1111/j.1365-2133.2011.10315.x.Journal
The British journal of dermatologyDOI
10.1111/j.1365-2133.2011.10315.xPubMed ID
21410679Abstract
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
engISSN
1365-2133 (Electronic)0007-0963 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1111/j.1365-2133.2011.10315.x
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