Association between quantitative varicella-zoster virus antibody levels and zoster reactivation in HIV-infected persons
Abstract Background Varicella-zoster virus (VZV) reactivation is common but difficult to predict in HIV-infected persons. Objective Since qualitative VZV antibodies can determine past VZV disease or vaccination, we evaluated whether quantitative VZV antibody levels over time can predict future zoste...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-12-01
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| Series: | AIDS Research and Therapy |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12981-018-0212-0 |
| _version_ | 1828433408654573568 |
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| author | Heather S. Pomerantz Xiaohe Xu James White T. S. Sunil Robert G. Deiss Anuradha Ganesan Brian K. Agan Jason F. Okulicz |
| author_facet | Heather S. Pomerantz Xiaohe Xu James White T. S. Sunil Robert G. Deiss Anuradha Ganesan Brian K. Agan Jason F. Okulicz |
| author_sort | Heather S. Pomerantz |
| collection | DOAJ |
| description | Abstract Background Varicella-zoster virus (VZV) reactivation is common but difficult to predict in HIV-infected persons. Objective Since qualitative VZV antibodies can determine past VZV disease or vaccination, we evaluated whether quantitative VZV antibody levels over time can predict future zoster. Study design US Military HIV Natural History (NHS) participants with a zoster diagnosis at least 5 years after HIV diagnosis (n = 100) were included. Zoster-negative controls (n = 200) were matched by age, race, gender, and CD4 count at HIV diagnosis. Repository plasma specimens collected at baseline and prior to zoster diagnosis were evaluated using a quantitative anti-VZV ELISA assay. Differences in quantitative VZV levels were analyzed by Wilcoxon Mann–Whitney and Fisher’s exact tests. Results Median CD4 count at HIV diagnosis was similar for cases and controls (535 [IQR 384–666] vs. 523 [IQR 377–690] cells/μL; p = 0.940), but lower for cases at zoster diagnosis (436 [IQR 277–631] vs. 527 [IQR 367–744] cells/μL; p = 0.007). Antiretroviral therapy (ART) use prior to zoster diagnosis was lower for cases (52.0%) compared to controls (64.5%; p = 0.025). Cases had similar mean VZV antibody levels prior to zoster diagnosis compared to controls [2.25 ± 0.85 vs. 2.44 ± 0.96 index value/optical density (OD) ratio; p = 0.151] with no difference in the change in antibody levels over time (0.08 ± 0.71 vs. 0.01 ± 0.94 index value/OD per year; p = 0.276). Conclusion Quantitative VZV antibody levels are stable in HIV-infected persons and do not predict zoster reactivation. Low CD4 count and lack of ART use appear to be better predictors of future zoster diagnosis. |
| first_indexed | 2024-12-10T18:34:01Z |
| format | Article |
| id | doaj.art-f43701af9b6f4b00ad958c762822be8f |
| institution | Directory Open Access Journal |
| issn | 1742-6405 |
| language | English |
| last_indexed | 2024-12-10T18:34:01Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | AIDS Research and Therapy |
| spelling | doaj.art-f43701af9b6f4b00ad958c762822be8f2022-12-22T01:37:51ZengBMCAIDS Research and Therapy1742-64052018-12-011511510.1186/s12981-018-0212-0Association between quantitative varicella-zoster virus antibody levels and zoster reactivation in HIV-infected personsHeather S. Pomerantz0Xiaohe Xu1James White2T. S. Sunil3Robert G. Deiss4Anuradha Ganesan5Brian K. Agan6Jason F. Okulicz7Infectious Disease Service, San Antonio Military Medical CenterSchool of Public Administration, Sichuan UniversitySchool of Public Administration, Sichuan UniversitySchool of Public Administration, Sichuan UniversityDivision of Infectious Diseases, Naval Medical Center San DiegoInfectious Disease Clinical Research Program, Preventive Medicine and Biostatistics Department, Uniformed Services UniversityInfectious Disease Clinical Research Program, Preventive Medicine and Biostatistics Department, Uniformed Services UniversityInfectious Disease Service, San Antonio Military Medical CenterAbstract Background Varicella-zoster virus (VZV) reactivation is common but difficult to predict in HIV-infected persons. Objective Since qualitative VZV antibodies can determine past VZV disease or vaccination, we evaluated whether quantitative VZV antibody levels over time can predict future zoster. Study design US Military HIV Natural History (NHS) participants with a zoster diagnosis at least 5 years after HIV diagnosis (n = 100) were included. Zoster-negative controls (n = 200) were matched by age, race, gender, and CD4 count at HIV diagnosis. Repository plasma specimens collected at baseline and prior to zoster diagnosis were evaluated using a quantitative anti-VZV ELISA assay. Differences in quantitative VZV levels were analyzed by Wilcoxon Mann–Whitney and Fisher’s exact tests. Results Median CD4 count at HIV diagnosis was similar for cases and controls (535 [IQR 384–666] vs. 523 [IQR 377–690] cells/μL; p = 0.940), but lower for cases at zoster diagnosis (436 [IQR 277–631] vs. 527 [IQR 367–744] cells/μL; p = 0.007). Antiretroviral therapy (ART) use prior to zoster diagnosis was lower for cases (52.0%) compared to controls (64.5%; p = 0.025). Cases had similar mean VZV antibody levels prior to zoster diagnosis compared to controls [2.25 ± 0.85 vs. 2.44 ± 0.96 index value/optical density (OD) ratio; p = 0.151] with no difference in the change in antibody levels over time (0.08 ± 0.71 vs. 0.01 ± 0.94 index value/OD per year; p = 0.276). Conclusion Quantitative VZV antibody levels are stable in HIV-infected persons and do not predict zoster reactivation. Low CD4 count and lack of ART use appear to be better predictors of future zoster diagnosis.http://link.springer.com/article/10.1186/s12981-018-0212-0HIVVaricella zoster virusMilitary |
| spellingShingle | Heather S. Pomerantz Xiaohe Xu James White T. S. Sunil Robert G. Deiss Anuradha Ganesan Brian K. Agan Jason F. Okulicz Association between quantitative varicella-zoster virus antibody levels and zoster reactivation in HIV-infected persons AIDS Research and Therapy HIV Varicella zoster virus Military |
| title | Association between quantitative varicella-zoster virus antibody levels and zoster reactivation in HIV-infected persons |
| title_full | Association between quantitative varicella-zoster virus antibody levels and zoster reactivation in HIV-infected persons |
| title_fullStr | Association between quantitative varicella-zoster virus antibody levels and zoster reactivation in HIV-infected persons |
| title_full_unstemmed | Association between quantitative varicella-zoster virus antibody levels and zoster reactivation in HIV-infected persons |
| title_short | Association between quantitative varicella-zoster virus antibody levels and zoster reactivation in HIV-infected persons |
| title_sort | association between quantitative varicella zoster virus antibody levels and zoster reactivation in hiv infected persons |
| topic | HIV Varicella zoster virus Military |
| url | http://link.springer.com/article/10.1186/s12981-018-0212-0 |
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