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Bolotin S, Hughes SL, Savage RD, McLachlan E, Severini A, Arnold C, Richardson S, Crowcroft NS, Deek S, Halperin SA, Brown KA, Hatchette T, Osman S, Gubbay JB, Science M. Maternal varicella antibodies in children aged less than one year: Assessment of antibody decay. PLoS One 2023; 18:e0287765. [PMID: 37948389 PMCID: PMC10637651 DOI: 10.1371/journal.pone.0287765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 06/13/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVES To investigate maternal antibody levels to varicella in infants <12 months of age in Ontario, Canada. STUDY DESIGN In this study, we included specimens from infants <12 months of age, born at ≥37 weeks gestational age, who had sera collected at The Hospital for Sick Children (Toronto, Canada) between 2014-2016. We tested sera using a glycoprotein-based enzyme-linked immunosorbent assay (gpELISA). We measured varicella susceptibility (antibody concentration <150mIU/mL) and mean varicella antibody concentration, and assessed the probability of susceptibility and concentration between one and 11 months of age using multivariable logistic regression and Poisson regression. RESULTS We found that 32% of 196 included specimens represented infants susceptible to varicella at one month of age, increasing to nearly 80% at three months of age. At six months of age, all infants were susceptible to varicella and the predicted mean varicella antibody concentration declined to 62 mIU/mL (95% confidence interval 40, 84), well below the threshold of protection. CONCLUSIONS We found that varicella maternal antibody levels wane rapidly in infants, leaving most infants susceptible by four months of age. Our findings have implications for the timing of first dose of varicella-containing vaccine, infection control measures, and infant post-exposure prophylaxis recommendations.
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Affiliation(s)
- Shelly Bolotin
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | | | - Rachel D. Savage
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth McLachlan
- National Microbiology Laboratory, Public Health Agency of Canada, Ottawa, Ontario, Canada
- Department of Medical Microbiology, University of Manitoba, Manitoba, Canada
| | - Alberto Severini
- National Microbiology Laboratory, Public Health Agency of Canada, Ottawa, Ontario, Canada
- Department of Medical Microbiology, University of Manitoba, Manitoba, Canada
| | - Callum Arnold
- Division of Infectious Diseases, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Susan Richardson
- Division of Microbiology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Natasha S. Crowcroft
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Department of Immunization, Vaccines & Biologicals, World Helath Organization, Geneva, Switzerland
| | - Shelley Deek
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Scott A. Halperin
- Canadian Center for Vaccinology (CCfV), IWK Health Centre, Nova Scotia Health (NSH), and Dalhousie University, Halifax, Nova Scotia (NS), Canada
| | - Kevin A. Brown
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Todd Hatchette
- Canadian Center for Vaccinology (CCfV), IWK Health Centre, Nova Scotia Health (NSH), and Dalhousie University, Halifax, Nova Scotia (NS), Canada
| | - Selma Osman
- Public Health Ontario, Toronto, Ontario, Canada
| | - Jonathan B. Gubbay
- Public Health Ontario, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Division of Infectious Diseases, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Michelle Science
- Public Health Ontario, Toronto, Ontario, Canada
- Division of Infectious Diseases, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
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Kombe Kombe AJ, Xie J, Zahid A, Ma H, Xu G, Deng Y, Nsole Biteghe FA, Mohammed A, Dan Z, Yang Y, Feng C, Zeng W, Chang R, Zhu K, Zhang S, Jin T. Detection of Circulating VZV-Glycoprotein E-Specific Antibodies by Chemiluminescent Immunoassay (CLIA) for Varicella-Zoster Diagnosis. Pathogens 2022; 11:pathogens11010066. [PMID: 35056014 PMCID: PMC8778750 DOI: 10.3390/pathogens11010066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 02/01/2023] Open
Abstract
Varicella and herpes zoster are mild symptoms-associated diseases caused by varicella–zoster virus (VZV). They often cause severe complications (disseminated zoster), leading to death when diagnoses and treatment are delayed. However, most commercial VZV diagnostic tests have low sensitivity, and the most sensitive tests are unevenly available worldwide. Here, we developed and validated a highly sensitive VZV diagnostic kit based on the chemiluminescent immunoassay (CLIA) approach. VZV-glycoprotein E (gE) was used to develop a CLIA diagnostic approach for detecting VZV-specific IgA, IgG, and IgM. The kit was tested with 62 blood samples from 29 VZV-patients classified by standard ELISA into true-positive and equivocal groups and 453 blood samples from VZV-negative individuals. The diagnostic accuracy of the CLIA kit was evaluated by receiver-operating characteristic (ROC) analysis. The relationships of immunoglobulin-isotype levels between the two groups and with patient age ranges were analyzed. Overall, the developed CLIA-based diagnostic kit demonstrated the detection of VZV-specific immunoglobulin titers depending on sample dilution. From the ELISA-based true-positive patient samples, the diagnostic approach showed sensitivities of 95.2%, 95.2%, and 97.6% and specificities of 98.0%, 100%, and 98.9% for the detection of VZV-gE-specific IgA, IgG, and IgM, respectively. Combining IgM to IgG and IgA detection improved diagnostic accuracy. Comparative analyses on diagnosing patients with equivocal results displaying very low immunoglobulin titers revealed that the CLIA-based diagnostic approach is overall more sensitive than ELISA. In the presence of typical VZV symptoms, CLIA-based detection of high titer of IgM and low titer of IgA/IgG suggested the equivocal patients experienced primary VZV infection. Furthermore, while no difference in IgA/IgG level was found regarding patient age, IgM level was significantly higher in young adults. The CLIA approach-based detection kit for diagnosing VZV-gE-specific IgA, IgG, and IgM is simple, suitable for high-throughput routine analysis situations, and provides enhanced specificity compared to ELISA.
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Affiliation(s)
- Arnaud John Kombe Kombe
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
| | - Jiajia Xie
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
| | - Ayesha Zahid
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Huan Ma
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Guangtao Xu
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Yiyu Deng
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Fleury Augustin Nsole Biteghe
- Gabonese Scientific Research Consortium, Libreville, Gabon;
- Department of Radiation Oncology, Cedars Sinai Hospital, Los Angeles, CA 90048, USA
| | - Ahmed Mohammed
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Zhao Dan
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Yunru Yang
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Chen Feng
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Weihong Zeng
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Ruixue Chang
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
| | - Keyuan Zhu
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
| | - Siping Zhang
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
- Correspondence: (S.Z.); (T.J.); Tel.: +86-0551-62283151 (S.Z.); +86-551-63600720 (T.J.)
| | - Tengchuan Jin
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
- CAS Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai 200031, China
- Correspondence: (S.Z.); (T.J.); Tel.: +86-0551-62283151 (S.Z.); +86-551-63600720 (T.J.)
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Swift MD, Behrman AJ. Vaccines for Health Care Personnel. Mayo Clin Proc 2019; 94:2127-2141. [PMID: 31515104 DOI: 10.1016/j.mayocp.2019.01.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/16/2019] [Accepted: 01/31/2019] [Indexed: 01/01/2023]
Abstract
Medical Center Occupational Health (MCOH) programs must protect health care personnel (HCP) against the occupational risk of vaccine-preventable diseases. This thematic review outlines the rationale for the use of recommended vaccines in HCP; summarizes the available evidence regarding vaccine effectiveness, administration, and assessment of immunity; and provides guidance for MCOH programs navigating challenging situations.
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Affiliation(s)
- Melanie D Swift
- Division of Preventive Occupational and Aerospace Medicine, Mayo Clinic, Rochester, MN.
| | - Amy J Behrman
- Department of Emergency Medicine, Perelman School of Medicine, Philadelphia, PA
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Peterson I, Ntsui N, Jambo K, Kelly C, Huwa J, Afran L, Tatuene JK, Pett S, Henrion MYR, Van Oosterhout J, Heyderman RS, Mwandumba H, Benjamin LA. Evaluating the reactivation of herpesviruses and inflammation as cardiovascular and cerebrovascular risk factors in antiretroviral therapy initiators in an African HIV-infected population (RHICCA): a protocol for a longitudinal cohort study. BMJ Open 2019; 9:e025576. [PMID: 31515413 PMCID: PMC6747662 DOI: 10.1136/bmjopen-2018-025576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION In Sub-Saharan Africa, the rising rates of cerebrovascular and cardiovascular diseases (CBD/CVD) are intersecting with an ageing HIV-infected population. The widespread use of antiretroviral therapy (ART) may confer an additive risk and may not completely suppress the risk associated with HIV infection. High-quality prospective studies are needed to determine if HIV-infected patients in Africa are at increased risk of CBD/CVD and to identify factors associated with this risk. This study will test the hypothesis that immune activation and dysfunction, driven by HIV and reactivation of latent herpesvirus infections, lead to increased CBD/CVD risk in Malawian adults aged ≥35 years. METHODS AND ANALYSIS We will conduct a single-centre, 36-month, prospective cohort study in 800 HIV-infected patients initiating ART and 190 HIV-uninfected controls in Blantyre, Malawi. Patients and controls will be recruited from government ART clinics and the community, respectively, and will be frequency-matched by 5-year age band and sex. At baseline and follow-up visits, we will measure carotid intima-media thickness and pulse wave velocity as surrogate markers of vasculopathy, and will be used to estimate CBD/CVD risk. Our primary exposures of interest are cytomegalovirus and varicella zoster reactivation, changes in HIV plasma viral load, and markers of systemic inflammation and endothelial function. Multivariable regression models will be developed to assess the study's primary hypothesis. The occurrence of clinical CBD/CVD will be assessed as secondary study endpoints. ETHICS AND DISSEMINATION The University of Malawi College of Medicine and Liverpool School of Tropical Medicine research ethics committees approved this work. Our goal is to understand the pathogenesis of CBD/CVD among HIV cohorts on ART, in Sub-Saharan Africa, and provide data to inform future interventional clinical trials. This study runs between May 2017 and August 2020. Results of the main trial will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER ISRCTN42862937.
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Affiliation(s)
- Ingrid Peterson
- Liverpool School of Tropical Medicine, Liverpool, UK
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Ntobeko Ntsui
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Kondwani Jambo
- Liverpool School of Tropical Medicine, Liverpool, UK
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Christine Kelly
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Jacqueline Huwa
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Louise Afran
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Joseph Kamtchum Tatuene
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - Sarah Pett
- Institute of Infection and Global Health, University College London, London, UK
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Marc Yves Romain Henrion
- Liverpool School of Tropical Medicine, Liverpool, UK
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Joep Van Oosterhout
- Department of Medicine, University of Malawi College of Medicine, Blantyre, Malawi
- Dignitas International, Zomba, Malawi
| | - Robert S Heyderman
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Division of Infection and Immunity, University College London, London, UK
| | - Henry Mwandumba
- Liverpool School of Tropical Medicine, Liverpool, UK
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Laura A Benjamin
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
- Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK
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Calibration and Evaluation of Quantitative Antibody Titers for Varicella-Zoster Virus by Use of the BioPlex 2200. J Clin Microbiol 2019; 57:JCM.00296-19. [PMID: 31167847 PMCID: PMC6663917 DOI: 10.1128/jcm.00296-19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/28/2019] [Indexed: 01/30/2023] Open
Abstract
Most commercially available enzyme immunoassay-based methods have limited sensitivity to detect antibody responses to varicella-zoster virus (VZV) in vaccinated individuals, who produce lower antibody levels than those with natural infection. However, more sensitive methods are either not commercially available or less amenable to high-throughput testing. Most commercially available enzyme immunoassay-based methods have limited sensitivity to detect antibody responses to varicella-zoster virus (VZV) in vaccinated individuals, who produce lower antibody levels than those with natural infection. However, more sensitive methods are either not commercially available or less amenable to high-throughput testing. The BioPlex 2200 measles, mumps, rubella, and varicella (MMRV) IgG assay (Bio-Rad Laboratories, Hercules, CA) is an automated high-throughput platform based on the microsphere Luminex technology that measures antibodies against measles, mumps, rubella, and varicella viruses simultaneously. Although it has U.S. Food and Drug Administration approval as a qualitative diagnostic test for measles, mumps, rubella, and varicella virus immunity, in this study, we have validated the assay to produce quantitative titers (off label) against the VaccZyme VZV glycoprotein (VZVgp) low-level IgG kit (The Binding Site Ltd., Birmingham, UK) using the World Health Organization international standard. Here, we show that the BioPlex 2200 MMRV IgG assay has sensitivity superior to that of the Zeus enzyme-linked immunosorbent assay (ELISA) VZV IgG assay (Zeus Diagnostics, Branchburg, NJ). Using receiver operating characteristic (ROC) analysis and adjusting the cutoff levels, we improved the sensitivity of the quantitative BioPlex 2200 MMRV IgG assay to 97.4%, while maintaining 100% specificity.
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Dubey AP, Faridi MMA, Mitra M, Kaur IR, Dabas A, Choudhury J, Mukherjee M, Mishra D. Safety and immunogenicity of Bio Pox™, a live varicella vaccine (Oka strain) in Indian children: A comparative multicentric, randomized phase II/III clinical trial. Hum Vaccin Immunother 2017; 13:2032-2037. [PMID: 28509605 PMCID: PMC5612528 DOI: 10.1080/21645515.2017.1318236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Varicella or chickenpox is a highly contagious disease with a high secondary attack rate. Almost 30% of Indian adolescents lack protective antibodies against varicella, emphasizing the need of routine varicella immunization. The Oka VZV is a well-established, safe and efficacious vaccine strain that is highly immunogenic and produces lifelong protective immunity. The present multicentric, open label, randomized, controlled Phase II/III study, compared the Bio Pox™ (indigenous investigational vaccine) with a licensed vaccine, Varivax™ [a][a] Please note that this article refers to the product named VARIVAX as manufactured by Changchun Keygen Biological Products Ltd., China and marketed in India by VHB Life Sciences Limited, Mumbai, and not the product VARIVAX® owned by Merck Sharp & Dohme Corp., Rahway, New Jersey, USA. Merck Sharp & Dohme Corp. have asked us to make clear that the product manufactured by Changchun Keygen Biological Products Ltd. is unrelated to and is not sponsored, endorsed or otherwise authorised by Merck Sharp & Dohme Corp. , for its safety and immunogenicity profile in 252 healthy subjects in the age group of 1-12 y (cohort I: 6-12 years, II:1-6 years) in 3 tertiary medical institutions. Antibodies were measured by VZV Glycoprotein Enzyme Linked Immunoassay (IgG ELISA) kit. Seroconversion percentage in children having pre-vaccination anti VZV IgG titer <10 mIU/mL (< 5 gp ELISA units/mL) were 80% for Bio Pox™ and 77% for Varivax™ (p = 0.692). The seroconversion rate in the group receiving Bio Pox™ was non-inferior to the group that received Varivax™. There were mild local reactions for both the vaccines; none of the patient had fever or required hospitalization or medication. The Bio Pox™ was found to be safe and immunogenic in children against VZV infection.
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Affiliation(s)
| | - Mohammad Moonis Akbar Faridi
- University College of Medical Sciences, Delhi, India
- CONTACT Mohammad Moonis Akbar Faridi ; MD, DCH, MNAMS, FIAP, FNNF, Director Professor and Head, University College of Medical Sciences, E-9 GTB Hospital Campus, Delhi-110095, India
| | | | - Iqbal Rajinder Kaur
- Department of Microbiology University College of Medical Sciences, Delhi, India
| | - Aashima Dabas
- Department of Pediatrics, Maulana Azad Medical College, New Delhi, India
| | | | | | - Devendra Mishra
- Department of Pediatrics, Maulana Azad Medical College, New Delhi, India
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De Paschale M, Clerici P. Microbiology laboratory and the management of mother-child varicella-zoster virus infection. World J Virol 2016; 5:97-124. [PMID: 27563537 PMCID: PMC4981827 DOI: 10.5501/wjv.v5.i3.97] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 07/08/2016] [Accepted: 07/22/2016] [Indexed: 02/05/2023] Open
Abstract
Varicella-zoster virus, which is responsible for varicella (chickenpox) and herpes zoster (shingles), is ubiquitous and causes an acute infection among children, especially those aged less than six years. As 90% of adults have had varicella in childhood, it is unusual to encounter an infected pregnant woman but, if the disease does appear, it can lead to complications for both the mother and fetus or newborn. The major maternal complications include pneumonia, which can lead to death if not treated. If the virus passes to the fetus, congenital varicella syndrome, neonatal varicella (particularly serious if maternal rash appears in the days immediately before or after childbirth) or herpes zoster in the early years of life may occur depending on the time of infection. A Microbiology laboratory can help in the diagnosis and management of mother-child infection at four main times: (1) when a pregnant woman has been exposed to varicella or herpes zoster, a prompt search for specific antibodies can determine whether she is susceptible to, or protected against infection; (2) when a pregnant woman develops clinical symptoms consistent with varicella, the diagnosis is usually clinical, but a laboratory can be crucial if the symptoms are doubtful or otherwise unclear (atypical patterns in immunocompromised subjects, patients with post-vaccination varicella, or subjects who have received immunoglobulins), or if there is a need for a differential diagnosis between varicella and other types of dermatoses with vesicle formation; (3) when a prenatal diagnosis of uterine infection is required in order to detect cases of congenital varicella syndrome after the onset of varicella in the mother; and (4) when the baby is born and it is necessary to confirm a diagnosis of varicella (and its complications), make a differential diagnosis between varicella and other diseases with similar symptoms, or confirm a causal relationship between maternal varicella and malformations in a newborn.
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MAPLE PAC, HAEDICKE J, QUINLIVAN M, STEINBERG SP, GERSHON AA, BROWN KE, BREUER J. The differences in short- and long-term varicella-zoster virus (VZV) immunoglobulin G levels following varicella vaccination of healthcare workers measured by VZV fluorescent-antibody-to-membrane-antigen assay (FAMA), VZV time-resolved fluorescence immunoassay and a VZV purified glycoprotein enzyme immunoassay. Epidemiol Infect 2016; 144:2345-53. [PMID: 27018820 PMCID: PMC5726866 DOI: 10.1017/s0950268816000595] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 02/04/2016] [Accepted: 03/02/2016] [Indexed: 01/31/2023] Open
Abstract
Healthcare workers (HCWs) reporting no history of varicella frequently receive varicella vaccination (vOka) if they test varicella-zoster virus (VZV) immunoglobulin G (IgG) negative. In this study, the utilities of VZV-IgG time-resolved fluorescence immunoassay (VZV-TRFIA) and a commercial VZV-IgG purified glycoprotein enzyme immunoassay (gpEIA) currently used in England for confirming VZV immunity have been compared to the fluorescent-antibody-to-membrane-antigen assay (FAMA). A total of 110 HCWs received two doses of vOka vaccine spaced 6 weeks apart and sera collected pre-vaccination (n = 100), at 6 weeks post-completion of vaccination (n = 86) and at 12-18 months follow-up (n = 73) were analysed. Pre-vaccination, by FAMA, 61·0% sera were VZV IgG negative, and compared to FAMA the sensitivities of VZV-TRFIA and gpEIA were 74·4% [95% confidence interval (CI) 57·9-87·0] and 46·2% (95% CI 30·1-62·8), respectively. Post-completion of vaccination the seroconversion rate by FAMA was 93·7% compared to rates of 95·8% and 70·8% determined by VZV-TRFIA and gpEIA, respectively. At 12-18 months follow-up seropositivity rates by FAMA, VZV-TRFIA and gpEIA were 78·1%, 74·0% and 47·9%, respectively. Compared to FAMA the sensitivities of VZV-TRFIA and gpEIA for measuring VZV IgG following vaccination were 96·4% (95% CI 91·7-98·8) and 74·6% (95% CI 66·5-81·6), respectively. Using both FAMA and VZV-TRFIA to identify healthy adult VZV susceptibles and measure seroconversion showed that vOka vaccination of HCWs is highly immunogenic.
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Affiliation(s)
- P. A. C. MAPLE
- Virus Reference Department, Public Health England, Reference Microbiology Services, Colindale, London, UK
- East Yorkshire Microbiology, York Science Park, Heslington, York, UK
| | - J. HAEDICKE
- Department of Infection, The Cruciform Building, University College London, London, UK
| | - M. QUINLIVAN
- Department of Infection, The Cruciform Building, University College London, London, UK
| | - S. P. STEINBERG
- Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, USA
| | - A. A. GERSHON
- Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, USA
| | - K. E. BROWN
- Virus Reference Department, Public Health England, Reference Microbiology Services, Colindale, London, UK
| | - J. BREUER
- Department of Infection, The Cruciform Building, University College London, London, UK
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9
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Evaluation of a multiplex bead immunoassay for determination of immune status to varicella-zoster virus in medical center students and employees. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2015; 22:351-3. [PMID: 25589555 DOI: 10.1128/cvi.00561-14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study evaluated an enzyme immunoassay, a multiplex bead immunoassay (MBIA), and the anticomplement immunofluorescence (ACIF) test for detecting varicella-zoster virus IgG antibodies in sera from medical center students and employees. The agreement between methods was ≥95%. The MBIA was less sensitive than was the ACIF test, with a negative predictive value of 66.7%.
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10
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Yu Q, Wang Q, Li B, Lin Q, Duan Y. Technological Development of Antibody Immobilization for Optical Immunoassays: Progress and Prospects. Crit Rev Anal Chem 2014. [DOI: 10.1080/10408347.2014.881249] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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11
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Maple PA, Beard S, Parry RP, Brown KE. Testing UK blood donors for exposure to human parvovirus 4 using a time-resolved fluorescence immunoassay to screen sera and Western blot to confirm reactive samples. Transfusion 2013; 53:2575-84. [DOI: 10.1111/trf.12278] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 04/11/2013] [Accepted: 04/20/2013] [Indexed: 12/11/2022]
Affiliation(s)
- Peter A.C. Maple
- Immunisation and Diagnosis Unit, Virus Reference Department; Public Health England; London UK
| | - Stuart Beard
- Immunisation and Diagnosis Unit, Virus Reference Department; Public Health England; London UK
| | - Ruth P. Parry
- Immunisation and Diagnosis Unit, Virus Reference Department; Public Health England; London UK
| | - Kevin E. Brown
- Immunisation and Diagnosis Unit, Virus Reference Department; Public Health England; London UK
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12
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Liu J, Ye Y, Hu Z, Zou Y, Chen G, Yu L. A hypersensitive biotin-avidin-TRFIA for quantitative detection of ANA-Ig(GAM) and its clinical application. J Immunoassay Immunochem 2013; 34:197-207. [PMID: 23537303 DOI: 10.1080/15321819.2012.699495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We demonstrate herein a novel time-resolved fluoroimmunoassay (TRFIA) with high sensitivity and wide range for quantitative detection of ANA-Ig(GAM) antibodies using a biotin-avidin amplification system. The immunoassay was conducted by following procedures for a typical sandwich immunoreactions with cell nucleus form Hela and the Eu(3+)-labeled biotin combined with biotinylated mouse anti-human Ig(GAM) served as the solid nuclear antigen for ANA and the tracer, respectively. The sensitivity, specificity, and stability of the kit were evaluated and comparison with the classical enzyme-linked immunosorbent assay (ELISA) kit was also made. The average intra-assay and interassay CVs detected by the established ANA-Ig(GAM) biotin-avidin-TRFIA were 4.21% and 6.34%, respectively. The lower detection limit was 2.24 U/mL, and the mean recovery rate was 100.74%. The good measurable range of the established biotin-avidin-TRFIA was within 1.95-64,000 U/mL, while it was only within 32.5-4000 U/mL using an ELISA kit. The values determined by the biotin-avidin-TRFIA and ELISA correlated well (R2 = 0.989). The positive rate of healthy volunteers and patients with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), primary biliary cirrhosis (PBC), Sjögren's syndrome (SS), scleroderma, and mixed connective tissue disease (MCTD) was 0, 100%, 18.5%, 100%, 37.9%, 90.9%, and 92%, respectively. We conclude that the biotin-avidin-TRFIA we developed gives promise for greater sensitivity and accurate detection for ANA-Ig(GAM) in diagnosing and monitoring autoimmune disorders.
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Affiliation(s)
- Jie Liu
- Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
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13
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Prelog M, Schönlaub J, Jeller V, Almanzar G, Höfner K, Gruber S, Eiwegger T, Würzner R. Reduced varicella-zoster-virus (VZV)-specific lymphocytes and IgG antibody avidity in solid organ transplant recipients. Vaccine 2013; 31:2420-6. [PMID: 23583889 DOI: 10.1016/j.vaccine.2013.03.058] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 02/04/2013] [Accepted: 03/28/2013] [Indexed: 02/01/2023]
Abstract
BACKGROUND Varicella-zoster-virus (VZV) infection may cause significant morbidity and mortality in immunocompromised patients. So far, only IgG-anti-VZV antibody concentrations were used to estimate immunity against VZV, but the antibody binding strength (avidity) together with VZV-specific cellular responses have not been evaluated in solid organ transplant (SOT) recipients. METHODS Thus, we assessed the humoral and cellular immune responses to two doses of the VZV vaccine (vacc) and wild-type VZV infection (wt) in 23 kidney (KTx) and 19 liver transplant (LTx) recipients including children and adults compared to 48 healthy controls (HC) for measurement of IgG-anti-VZV relative avidity index (RAI) and frequency of VZV-specific peripheral blood mononuclear cells (PBMCs) in vaccinated individuals using an adapted ELISA and IFN-gamma ELISPOT, respectively. RESULTS KTx(wt) (median RAI 72.3%) or LTx(wt) (79.2%) and KTx(vacc) (91.0%) or LTx(vacc) (72.5%) showed lower avidities compared to HC(wt) (84.5%) and HC(vacc) (94.0%), respectively, despite equally distributed IgG-anti-VZV concentrations. RAI>60% (high avidity) was detected in all HC, but only in 69.0% of SOT patients. KTx(vacc) (median 64 spot forming units SFU/500,000 PBMCs) and LTx(vacc) (67 SFU) had significantly lower VZV-specific cellular responses compared to HC(vacc) (268 SFU). CONCLUSIONS The diminished cellular reactivity to VZV has to be considered in SOT patients receiving immunosuppressive treatments when evaluating immunity against VZV. IgG antibody avidity and VZV-specific cellular responses may serve as additional markers to evaluate immunity against VZV in SOT recipients. The role of wild-type exposures and endogenous VZV re-activation on long-term immunity in SOT patients has to be awaited to establish recommendations for vaccine spacing in these patients, considering immunogenicity and safety aspects.
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Affiliation(s)
- Martina Prelog
- Department of Pediatrics, Innsbruck Medical University, Innsbruck, Austria.
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14
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Serologic analysis of the IgG antibody response in children with varicella zoster virus wild-type infection and vaccination. Pediatr Infect Dis J 2012; 31:1148-52. [PMID: 22863912 DOI: 10.1097/inf.0b013e31826bac27] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
INTRODUCTION In contrast to varicella zoster virus (VZV) primary infection, VZV vaccination does not seem to provide lifelong immunity against varicella. Because more people get vaccinated every year, the development of sensitive serological test systems for the detection of protective anti-VZV IgG will become important in the future. METHODS We have previously developed a novel VZV line assay based on 5 different recombinant VZV antigens. In this study, we compared this novel assay with a commercially available glycoprotein enzyme immunoassay (RIDASCREEN VZV IgG) in detecting anti-VZV IgG of children with previous varicella infection and VZV vaccination. RESULTS One hundred twenty-five children were included in this study, 72 with a history of varicella infection and 53 with VZV vaccination. Both assays detected anti-VZV IgG antibodies in both study groups with similar sensitivities. The VZV line assay revealed striking differences in the anti-VZV IgG composition against the VZV open reading frames, 4, 14 and 49, between both study groups, indicating that wild-type varicella infection causes a more diverse immune response against VZV than does vaccination. The exploitation of these results enabled the discrimination of both study groups with a sensitivity of 0.93 and a specificity of 0.83, indicating that the serologic differentiation of children with previous varicella infection and VZV vaccination might be possible. CONCLUSION The VZV line assay enables the detection of anti-VZV IgG with sensitivities comparable to glycoprotein enzyme immunoassays and might be suitable for the serologic discrimination between children with a history of varicella infection and VZV vaccination.
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