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Relationship of Titer to Varicella-Zoster Infection

John J. Hutter, Jr, MD; Linda L. Minnich, MS; C. George Ray, MD

Am J Dis Child. 1984;138(1):56-59.

Abstract
• Serum varicella-zoster (VZ) antibody titers were determined by a simple, indirect immunofluorescent antibody technique in 50 children with leukemia or non-Hodgkin's lymphoma. Sixteen children had initial antibody titers that were not detectable at a serum dilution of 1:8 and were considered to be susceptible to varicella. Thirty-one patients had initial serum VZ antibody titers of 1:16 or greater, while three had levels of 1:8. The serum antibody titer was 1:8 or greater in 16 children with a history of varicella. Seven episodes of localized herpes zoster were observed in children whose VZ titer was 1:8 or greater prior to onset. Two nonfatal infections with primary varicella developed in children with leukemia in remission whose initial titers were less than 1:8 and were associated with a convalescent rise in VZ antibody to levels greater than 1:16. Three susceptible children received zoster immune plasma or zoster immune globulin for varicella exposure, causing a transient rise in serum VZ titer. The assessment of serum VZ titer by this immunofluorescent antibody technique combined with the prior varicella history is useful in defining the population of children with leukemia and non-Hodgkin's lymphoma who are susceptible to primary varicella.

(AJDC 1984;138:56-59)

Author Affiliations
From the Departments of Pediatrics (Drs Hutter and Ray) and Pathology (Dr Ray and Ms Minnich), University of Arizona Health Sciences Center, Tucson.

Footnotes
Read in part before the annual meeting of the American Academy of Pediatrics, Section of Oncology-Hematology, New York, Oct 26, 1982.

Reprint requests to Department of Pediatrics, Arizona Health Sciences Center, 1501 N Campbell Ave, Tucson, AZ 85724 (Dr Hutter).

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