Varicella-Zoster Virus Antibody (IgM)

The Varicella-Zoster Virus Antibody (IgM) test contains 1 test with 1 biomarker.

Brief Description: The Varicella-Zoster Virus IgM Antibody test is a vital tool in diagnosing recent infections caused by the Varicella-Zoster Virus (VZV), which is responsible for chickenpox and shingles. This test detects the presence of IgM antibodies, providing valuable insight into the immune response to an ongoing or recent VZV infection.

Also Known As: Varicella Titer Test, VZV Titer Test, VZV Test, Varicella Test, VZV Antibody Test, Chicken Pox Test, Shingles Test, Herpes Zoster Virus Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Varicella-Zoster Virus IgM Antibody test ordered?

VZV antibody testing may be requested when a healthcare provider wants to see if a patient has recently been infected with VZV, especially if the patient is at high risk, such as an organ transplant recipient or a pregnant woman.

When a person at risk, such as a newborn or someone who is immunocompromised, has been exposed to VZV and is ill with atypical and/or severe symptoms, a VZV culture or DNA test may be ordered to detect an active primary VZV infection in the baby or a primary or reactivated infection in the immunocompromised person.

What does a Varicella-Zoster Virus IgM Antibody blood test check for?

The varicella zoster virus, a member of the herpes virus family, is responsible for chickenpox and shingles. Antibodies produced by the immune system in response to a VZV infection or the virus itself are detected in varicella zoster virus tests.

To detect and diagnose a current or previous infection with VZV, tests for chickenpox and shingles may be used. Testing is not always necessary to diagnose a current infection because clinical signs and symptoms are often suffice, but in some persons with unusual skin lesions, a diagnostic test can assist confirm the illness. The tests may be used to detect a present infection in some people, particularly organ transplant recipients and pregnant women, or to establish whether or not they have developed immunity from a previous infection or immunization.

VZV affected practically everyone in the United States by adulthood before the release and widespread use of a chickenpox vaccine in 1995. While VZV is present in latent form in many adults who were infected as children, the prevalence of new episodes of chickenpox has decreased dramatically, according to the Centers for Disease Control and Prevention. The vaccine is around 98 percent effective in avoiding illness after two doses, and those who do get sick usually have milder symptoms.

Chickenpox can be caused by the Varicella zoster virus in children and adults who have not been vaccinated or exposed previously. The primary illness is highly contagious, and it can be spread from person to person by coughing, sneezing, or touching blister fluid. Signs and symptoms of a primary infection include an itchy rash that appears two weeks after virus introduction, followed by the creation of pimple-like papules that turn into small, fluid-filled blisters (vesicles). The vesicles rupture, forming a crust, and then healing. Over the course of a few days, this process proceeds in two or three waves or "crops" of several hundred vesicles.

The virus becomes dormant after the original infection has passed, remaining in sensory nerve cells. During the infection, the person produces antibodies that usually prevent them from contracting chickenpox again. The virus can reactivate later in life particularly in persons with compromised immune systems, traveling down the nerve cells to the skin and causing shingles.

A mild to intense burning or itching discomfort in a band of skin at the waist, face, or another area is a symptom of shingles. It normally occurs in one region on one side of the body, although it can also happen in many places. A rash with or without vesicles occurs in the same region many days after the pain, itching, or tingling begins. The rash and pain go away in most people after a few weeks, and the virus becomes latent again. A few people may experience pain that lasts for months.

For elderly persons, a shingles vaccination is now available. This vaccine reduces the chances of the virus reactivating as shingles and the severity of the symptoms if it does. The Advisory Committee on Immunization Practices started recommending a shingles vaccine for all persons aged 60 and up in 2006. The vaccination, however, is not suggested for people with weaker immune systems.

The majority of chickenpox and shingles cases go away on their own. The condition can be more severe and long-lasting in persons with weaker immune systems, such as those with HIV/AIDS or organ transplant recipients. It may not become latent in some circumstances and spread to the central nervous system.

The consequences of VZV exposure on a developing baby or infant in pregnant women vary depending on when it occurs and whether or not the mother has already been exposed. A primary VZV infection in the first 20 to 30 weeks of pregnancy might cause congenital defects in the unborn infant. The infant may be born with or acquire chickenpox after birth if the illness begins one to three weeks before delivery, though the newborn may be partially protected by the mother's antibodies. VZV infection can be lethal if a newborn is exposed to it at birth and does not have maternal antibody protection.

Lab tests often ordered with a Varicella-Zoster Virus IgM Antibody test:

When a VZV IgM test is ordered, it's often part of a broader evaluation of a suspected VZV infection and its potential complications. Here are some tests commonly ordered alongside it:

1. Varicella-Zoster Virus IgG Antibody Test:

   • Purpose: To determine past exposure or immunity to the VZV.
   • Why Is It Ordered: To differentiate between a primary infection (chickenpox) and reactivation (shingles). IgG antibodies typically indicate past exposure or immunity.

2. Complete Blood Count (CBC) with Differential:

   • Purpose: To evaluate overall blood health.
   • Why Is It Ordered: To check for signs of infection or complications, such as secondary bacterial infection.

3. Liver Function Test:

   • Purpose: To assess liver health.
   • Why Is It Ordered: To evaluate for liver involvement, as VZV infection can occasionally affect liver function.

4. Herpes Simplex Virus (HSV) Testing:

   • Purpose: To differentiate between VZV and HSV, which can cause similar skin lesions.
   • Why Is It Ordered: To rule out HSV in cases where blistering lesions are present, as HSV can mimic shingles.

5. Blood Urea Nitrogen (BUN) and Creatinine:

   • Purpose: To assess kidney function.
   • Why Is It Ordered: To evaluate for complications, particularly if antiviral treatment is considered, as some antivirals can affect kidney function.

These tests, when ordered alongside a Varicella-Zoster Virus IgM Antibody test, provide a comprehensive evaluation of a suspected VZV infection. They are crucial for diagnosing VZV, differentiating it from other conditions with similar symptoms, assessing the severity of the infection, and guiding appropriate treatment. The specific combination of tests will depend on the individual’s symptoms, clinical presentation, and medical history.

Conditions where a Varicella-Zoster Virus IgM Antibody test is recommended:

The Varicella-Zoster Virus IgM Antibody test is crucial for diagnosing:

• Chickenpox (Primary VZV Infection): This highly contagious viral infection typically occurs in childhood, causing characteristic itchy blisters.

• Shingles (Herpes Zoster): This occurs when the virus reactivates in individuals who previously had chickenpox. It causes a painful rash usually localized to one side of the body.

How does my health care provider use a Varicella-Zoster Virus IgM Antibody test?

Active cases of chickenpox and shingles, which are caused by the varicella zoster virus, are not usually diagnosed using laboratory tests. The signs and symptoms of these illnesses are frequently used to make a diagnosis. Because most adults have been infected with VZV and children have been vaccinated, there is no need for widespread population screening. In some circumstances, however, testing for VZV or antibodies generated in response to VZV infection may be necessary. It may be used in pregnant women, neonates, individuals awaiting organ transplantation, and those living with HIV/AIDS, for example. Testing can be done to see if someone has developed immunity to VZV after being exposed to it previously, either by infection or vaccination.

What do my Varicella Zoster test results mean?

Detection of IgM antibodies are used to determine whether or not a person has experienced recent infection.

Most Common Questions About the Varicella-Zoster Virus IgM Antibody test:

Purpose and Applications

Why is the Varicella-Zoster Virus IgM Antibody test ordered?

The Varicella-Zoster Virus IgM Antibody test is typically ordered to confirm an acute infection with the Varicella-Zoster Virus (VZV), which causes chickenpox and shingles. The presence of IgM antibodies indicates a recent or current infection.

How does the Varicella-Zoster Virus IgM Antibody test differentiate between chickenpox and shingles?

The test itself doesn't differentiate between chickenpox and shingles. Both are caused by the same virus. The diagnosis of chickenpox or shingles is based on the clinical presentation of the patient. The test merely confirms the presence of a recent or current VZV infection.

Clinical Significance

If I had chickenpox or a vaccine in the past, would the Varicella-Zoster Virus IgM Antibody test be positive?

No. The IgM antibody is an indicator of a recent or ongoing infection. Past infections or vaccinations would lead to the presence of IgG antibodies, not IgM.

Can the Varicella-Zoster Virus IgM Antibody test be used to determine immunity to chickenpox or shingles?

No. To determine immunity, you would typically test for Varicella-Zoster Virus IgG antibodies, which remain in the blood long-term after infection or vaccination and provide immunity.

Interpretation

What does a positive Varicella-Zoster Virus IgM Antibody test result mean?

A positive result indicates that the individual has a recent or current infection with the Varicella-Zoster Virus. This could be either a primary infection (chickenpox) or a reactivation of the virus (shingles).

What does a negative Varicella-Zoster Virus IgM Antibody test result mean?

A negative result suggests that the individual does not have a recent or ongoing VZV infection. However, it does not rule out the possibility of a past infection or vaccination.

Additional Considerations

Can other infections cause a positive Varicella-Zoster Virus IgM Antibody test?

While the test is specific to VZV, false positives can sometimes occur due to cross-reactivity with other herpesviruses. Therefore, clinical correlation and additional tests might be needed for a definitive diagnosis.

If someone is symptomatic but tests negative for Varicella-Zoster Virus IgM, what should be the next step?

It's possible for someone to test negative early in the course of the disease. If VZV infection is highly suspected, the test might be repeated after some days. Additionally, other diagnostic tests or evaluations might be considered based on the patient's symptoms and presentation.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.