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Viral load and antibody boosting following herpes zoster diagnosis

Warren-Gash, C; Forbes, H; Maple, P; Quinlivan, M; Breuer, J; (2018) Viral load and antibody boosting following herpes zoster diagnosis. Journal of Clinical Virology , 103 pp. 12-15. 10.1016/j.jcv.2018.03.010. Green open access

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Abstract

BACKGROUND: Acute varicella zoster virus (VZV) replication in shingles is accompanied by VZV antibody boosting. It is unclear whether persisting virus shedding affects antibody levels. OBJECTIVES: To investigate the relationship between VZV viral load and antibody titres in shingles patients during six months following diagnosis and assess whether VZV antibody titre could discriminate patients with recent shingles from healthy population controls. STUDY DESIGN: A prospective study of 63 patients with active zoster. Blood samples were collected at baseline, one, three and six months to measure VZV DNA and IgG antibody titre. We compared VZV antibody titres of zoster patients and 441 controls. RESULTS: In acute zoster, viral load was highest at baseline and declined gradually over the following six months. Mean antibody titres rose fourfold, peaking at one month and remaining above baseline levels throughout the study. Antibody levels at one, three and six months after zoster were moderately correlated with baseline but not subsequent viral load. Regarding use of antibody titres to identify recent shingles, to achieve 80% sensitivity, specificity would be 23.4%, 67.7%, 64.8% and 52.6%, at baseline, visit 2, 3 and 4 respectively, whilst to achieve 80% specificity, sensitivity would be 28.3%, 66.1%, 52.6%, 38.6%, at baseline, visit 2, 3 and 4 respectively. CONCLUSIONS: Clinical VZV reactivation boosted VZV antibody levels and the level of boosting was dependent upon baseline viral replication. While antibody titres could discriminate patients with shingles 1-6 months earlier from blood donor controls, there was a large trade-off between sensitivity and specificity.

Type: Article
Title: Viral load and antibody boosting following herpes zoster diagnosis
Location: Netherlands
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jcv.2018.03.010
Publisher version: http://dx.doi.org/10.1016/j.jcv.2018.03.010
Language: English
Additional information: © 2018 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/BY/4.0/).
Keywords: Antibody, Herpes zoster, Varicella zoster virus, Viral load
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10047040
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