Bates C J, Kudesia G, McKendrick M W
Sheffield Public Health Laboratory, England.
J Med Virol. 1996 Nov;50(3):244-8. doi: 10.1002/(SICI)1096-9071(199611)50:3<244::AID-JMV6>3.0.CO;2-9.
The serological response of patients with acute herpes zoster was studied to determine whether a diagnosis could be made on a single serum sample, and whether this response was modified by treatment with antiviral and/or steroid therapy. The patients received one of four regimes of acyclovir and prednisolone, Varicella zoster virus (VZV) IgG, IgM, and IgA responses were measured by commercial and in-house enzyme immunoassays (EIA) using serum samples taken at days 0, 7, and 21 after entry into the study. Samples were also tested for IgM to Epstein-Barr virus (EBV) viral capsid antigen (VCA), and cytomegalovirus (CMV) IgM and for herpes simplex virus (HSV) antibodies by the complement fixation test (CFT). Analysis was carried out on data from 71 patients. VZV IgM was detected in 72%, VZV IgA in 78%, and either VZV IgM or IgA in 88% of patients tested, at some time during the 3-week study period. The optimal time to detect either class of antibody was approximately 1 week after the onset of the vesicular rash, when 85% of patients had one or both classes of acute phase antibody in their serum. There was no evidence of cross reaction with EBV, CMV, or HSV antibodies. Neither treatment with prednisolone nor the length of therapy with acyclovir affected significantly the VZV IgM or IgA responses. Therefore it is possible to make a serological diagnosis of herpes zoster on a single sample, optimally 1 week after the onset of the rash, in patients treated with acyclovir alone or with acyclovir and steroids.
对急性带状疱疹患者的血清学反应进行了研究，以确定是否可以通过单一血清样本做出诊断，以及这种反应是否会因抗病毒和/或类固醇治疗而改变。患者接受了四种阿昔洛韦和泼尼松龙治疗方案中的一种，使用研究入组后第0天、第7天和第21天采集的血清样本，通过商业和内部酶免疫测定（EIA）测量水痘带状疱疹病毒（VZV）IgG、IgM和IgA反应。还通过补体结合试验（CFT）检测样本中针对爱泼斯坦-巴尔病毒（EBV）病毒衣壳抗原（VCA）的IgM、巨细胞病毒（CMV）IgM以及单纯疱疹病毒（HSV）抗体。对71例患者的数据进行了分析。在为期3周的研究期间，72%的患者检测到VZV IgM，78%的患者检测到VZV IgA，88%的患者检测到VZV IgM或IgA。检测到任何一类抗体的最佳时间约为水疱疹发作后1周，此时85%的患者血清中有一种或两种急性期抗体。没有证据表明与EBV、CMV或HSV抗体发生交叉反应。泼尼松龙治疗和阿昔洛韦治疗时间均未显著影响VZV IgM或IgA反应。因此，对于单独使用阿昔洛韦或同时使用阿昔洛韦和类固醇治疗的患者，在皮疹发作后1周（最佳时间）采集的单一样本上进行带状疱疹的血清学诊断是可行的。
