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Varicella Zoster Virus (VZV) IgG

VZV IgG, Chicken pox, Varicella-Zoster Virus Antibody, IgG

Test Codes

EPIC: LAB6899, Beaker: VZOIG

Department

Special Chemistry

Specimen Collection Criteria

Collect: One Gold-top SST tube.

Physician Office/Draw Specimen Preparation

Let specimen clot 30-60 minutes then centrifuge to separate serum from cells. Refrigerate (2-8°C or 36-46°F) the centrifuged collection tube within two hours of collection. (Minimum Serum: 0.5 mL)

Preparation for Courier Transport

Transport: Centrifuged collection tube, refrigerated (2-8 °C or 36-46 °F). (Minimum Serum: 0.5 mL)

Rejection Criteria

• Plasma specimens.
• Severely lipemic, icteric, or hemolyzed specimens.

In-Lab Processing

Let specimen clot 30-60 minutes then centrifuge to separate serum from cells. Room temperature is acceptable for a maximum of two hours. (Minimum Serum: 0.5 mL)

Storage

Specimen Stability for Testing:

Centrifuged SST Tubes and Microtainers^® with Separator Gels
Room Temperature (20-26°C or 68-78.8°F): 8 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Red-top Tubes and Microtainers^® without Separator Gels
Room Temperature (20-26°C or 68-78.8°F): 8 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Serum Specimens (Pour-Overs)
Room Temperature (20-26°C or 68-78.8°F): 8 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 3 months

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Royal Oak Special Testing Laboratory

Performed

Tuesday – Saturday.
Results available within 2 business days.

Reference Range

Negative:  ≤ 0.7 U
Equivocal:  0.8-0.9 U
Positive:  ≥ 1.0 U

Test Methodology

Multiplex Flow Assay.

Interpretation

This test should not be used to verify seroconversion after vaccination. However, it can detect seroconversion to a natural infection with varicella zoster virus.

Clinical Utility

• Serological testing for IgG antibodies to Varicella-Zoster virus (VZV) is done to confirm a recent infection or to determine past natural VZV infection.
• Varicella-Zoster IgG antibodies are first detectable 4-6 days after the onset of rash, peaking after 4-8 weeks. Varicella-Zoster antibody titers remain elevated for 6-8 months then decline 4-8 fold. Varicella-Zoster IgG antibodies will normally persist at low levels indefinitely. VZV-specific IgG3 antibodies are predominant in chickenpox whereas VZV-specific IgG1 is the dominant subclass in shingles (1).

Clinical Disease

• Varicella-zoster virus causes two distinct diseases: varicella (chickenpox) and herpes zoster (shingles).
• Chickenpox is a seasonal childhood disease characterized by low grade fever, malaise, and a generalized vesicular rash. Chickenpox may occur after exposure to either chickenpox or shingles and is a manifestation of primary VZV infection. VZV infection during pregnancy causes birth defects in rare cases. When infection occurs at term, life threatening infections can occur in the neonate.
• Shingles exhibits no seasonality and it usually occurs in immunocompromised patients and in older adults. Evidence suggests that shingles results from a reactivation of virus that remains latent in the sensory spinal ganglia after the primary infection rather than a reintroduction of the virus into the host. It is characterized by painful vesicular eruptions of the skin along the distribution of the involved nerves.

Epidemiology

Most varicella cases occur in winter and early spring with peak incidence in March and April. Epidemics occur at irregular 5 year intervals (1).

Incubation Period

11-21 days with a mean of 13-17 days (1).

Transmission

VZV is highly contagious and transmission is via direct contact and through droplets. Patients are infectious 1-2 days before the rash appears and for 3-5 days thereafter (1).

Reference

1. Wiedbrauk D, Johnston SLG. Manual of Clinical Virology, Raven Press, New York, NY, 1993.

CPT Codes

86787
LOINC: 15410-4, 21598-8

Contacts

Last Updated

2/10/2024