Antibodies to varicella zoster virus: no role in prognosis of Herpes zoster

Abstract number: 1134_03_305

Opstelten W., Essen G.A., Wijck A.J.M., Moons K.G.M., Kalkman C.J., Loon A.M., Verheij T.J.M.

Objectives:  

To measure antibodies (IgA, IgM, and IgG) to varicella-zoster (VZ) virus in patients with clinical herpes zoster (HZ) and to relate these findings to clinical symptoms of acute HZ and to the occurrence of postherpetic neuralgia (PHN).

Methods:  

Prospective study of elderly (>50 years) patients presenting to their general practitioner with acute HZ (rash <1 week). Personal and demographic data were registered from patients and pain was assessed using visual analogue scale and quality of life questionnaires. Blood samples were collected at baseline and one week later and analysed for IgA, IgG, and IgM. Pain was assessed at the initial visit and subsequently after 1, 2, 3, 4, 8, 12, and 26 weeks.

Results:  

270 patients were included. In 26 (10%) of them HZ could not be serologically confirmed. A significant association was found between titers of IgA and IgG at the initial visit and age and severity and duration of rash. There was no significant association between reported pain and titers of antibodies. Serological data did not contribute to the prediction of occurrence of PHN.

Conclusions:  

The clinical diagnosis of HZ made by the general practitioner can be serologically confirmed in most cases. The titers of antibodies are correlated with the severity and duration of the rash. They are, however, not associated with the intensity of pain, neither are they predictive for the duration of pain.