Relationship between preexisting anti-varicella-zoster virus (VZV) antibody and clinical VZV reactivation in hematopoietic stem cell transplantation recipients.

摘要

Reactivation of latent varicella zoster virus (VZV), presenting as localized zoster or asdisseminated infection, is a common and potentially serious complication in hematopoieticstem cell transplantation (HSCT) recipients. We retrospectively studied anti-VZV IgGtiters by the immune adherence hemagglutination method after HSCT and VZV DNA byreal-time PCR during clinical VZV reactivation using cryopreserved serum samples. Nosignificant difference was found between anti-VZV titers in 13 patients with VZV infection(localized zoster in 11 patients and disseminated zoster in 2 patients) and those in 13subjects without VZV infection at each time point after HSCT. Pre-existing anti-VZV titersof disseminated zoster cases tended to be lower than those of localized zoster cases(P=0.10). Serum VZV-DNA copy numbers at onset of disseminated zoster cases tendedto be higher than those of localized zoster cases (P=0.09). A strong inverse correlationwas found between pre-existing anti-VZV titer and serum VZV-DNA at onset (r=-0.90,P=0.006). In HSCT recipients, pre-existing antibody does not prevent development ofVZV reactivation but may contribute to decreased viral load at onset, resulting in a mildclinical course.