Sign in →

Test Code VZGM Varicella-Zoster Antibody, IgM and IgG (Separate Determinations), Serum

Reporting Name

Varicella-Zoster Ab, IgM and IgG, S

Useful For

Laboratory diagnosis of acute/recent infection with varicella-zoster virus (VZV)

 

Determination of immune status of individuals to the VZV

 

Documentation of previous infection with VZV in an individual without a previous record of immunization to VZV

Profile Information

Test ID Reporting Name Available Separately Always Performed
VZM Varicella-Zoster Ab, IgM, S Yes Yes
VZPG Varicella-Zoster Ab, IgG, S Yes Yes

Performing Laboratory

Mayo Medical Laboratories in Rochester

Specimen Type

Serum


Specimen Required


Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 1 mL


Specimen Minimum Volume

0.6 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 14 days
  Frozen  14 days

Reference Values

IgM

Negative (reported as negative or positive)

 

IgG

Vaccinated: positive (≥1.1 AI)

Unvaccinated: negative (≤0.8 AI)

Day(s) and Time(s) Performed

Monday through Saturday, 9 a.m.

CPT Code Information

86787-Varicella IgG

86787-Varicella IgM

LOINC Code Information

Test ID Test Order Name Order LOINC Value
VZGM Varicella-Zoster Ab, IgM and IgG, S In Process

 

Result ID Test Result Name Result LOINC Value
80964 Varicella-Zoster Ab, IgM, S 43588-3
VZG Varicella-Zoster Ab, IgG, S 15410-4
DEXG4 Varicella IgG Antibody Index 5403-1

Clinical Information

Varicella-zoster virus (VZV), a herpesvirus, causes 2 distinct exanthematous (rash-associated) diseases: chickenpox (varicella) and shingles (herpes zoster). Chickenpox is a highly contagious, though typically benign disease, usually contracted during childhood. Chickenpox is characterized by a dermal vesiculopustular rash that develops in successive crops approximately 10 to 21 days following exposure.(1) Although primary infection with VZV results in immunity and protection from subsequent infection, VZV remains latent within sensory dorsal root ganglia and upon reactivation, manifests as herpes zoster or shingles. During reactivation, the virus migrates along neural pathways to the skin, producing a unilateral rash, usually limited to a single dermatome. Shingles is an extremely painful condition typically occurring in older nonimmune adults or those with waning immunity to VZV and in patients with impaired cellular immunity.(2)

 

Individuals at risk for severe complications following primary VZV infection include pregnant women, in whom the virus may spread through the placenta to the fetus, causing congenital disease in the infant. Additionally, immunosuppressed patients are at risk for developing severe VZV-related complications, which include cutaneous disseminated disease and visceral organ involvement.(2,3)  

 

Serologic screening for IgG-class antibodies to VZV will aid in identifying nonimmune individuals. The presence of IgM-class antibodies to VZV is suggestive of acute or recent infection however results should be correlated with clinical presentation.

Interpretation

A positive IgG result coupled with a positive IgM result suggests recent infection with varicella-zoster virus (VZV). This result should not be used alone to diagnose VZV infection and should be interpreted in the context of clinical presentation.

 

A positive IgG result coupled with a negative IgM result indicates previous vaccination to or infection with VZV. These individuals are considered to have protective immunity to reinfection.

 

A negative IgG result coupled with a negative IgM result indicates the absence of prior exposure to VZV and nonimmunity. However, a negative result does not rule out a VZV infection. The specimen may have been drawn before the appearance of detectable antibodies. Negative results in suspected early VZV infections should be followed by testing a new serum specimen in 2 to 3 weeks.

 

Equivocal results should be followed up with testing of a new serum specimen within 10 to 14 days.

Clinical Reference

1. Yankowitz J, Grose C: Congenital infections. In Essentials of Diagnostic Virology. Edited by GA Storch. Churchill Livingstone, New York, 2000, pp 187-201

2. Gnann JW, Whitley RJ: Herpes Zoster. N Engl J Med 2002;347:340-346

3. Cvjetkovic D, Jovanovic J, Hrnjakovic-Cvjetkovic I, et al: Reactivation of herpes zoster infection by varicella-zoster virus. Med Pregl 1999;52(3):125-128

Analytic Time

Same day/1 day

Reject Due To

Hemolysis

Mild OK; Gross reject

Lipemia

Mild OK; Gross reject

Icterus

NA

Other

Heat-inactivated specimen

Method Name

VZM: Immunofluorescence Assay (IFA)

VZPG: Multiplex Flow Immunoassay (MFI)