Test ID VZGM Varicella-Zoster Antibody, IgM and IgG, Serum
Reporting Name
Varicella-Zoster Ab, IgM and IgG, SUseful For
Laboratory diagnosis of acute and 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 |
Specimen Type
SerumSpecimen 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 | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 14 days | |
Frozen | 14 days |
Reference Values
IgM
Negative
Reference values apply to all ages.
IgG
Vaccinated: positive (≥1.1 AI)
Unvaccinated: negative (≤0.8 AI)
Reference values apply to all ages.
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 | 81234-7 |
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 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: Storch GA, ed. Essentials of diagnostic virology. Churchill Livingstone; 2000: 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
4. Whitely RJ: Chickenpox and Herpes Zoster (Varicella-Zoster virus). In Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020: 1849-1856
Analytic Time
Same day/1 dayMethod Name
VZM: Immunofluorescence Assay (IFA)
VZPG: Multiplex Flow Immunoassay (MFI)
Test Classification
This test has been cleared, approved or is exempt by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.