Complement Fixation Studies with a Varicella-Zoster Antigen

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Abstract
Discussion and Summary: A satisfactory complement-fixing varicella or zoster antigen can be prepared from tissue culture cells infected with these agents. The two agents are antigenically indistinguishable and either antigen may be used to measure the antibody response to either infection. The studies with the complement fixation test are consistent with the results of other investigators (3, 4) and provide the basis for the statement that varicella and herpes zoster viruses are identical. The apparently more rapid development of antibody following zoster in comparison with varicella may represent a secondary or booster response, or may simply indicate that dating the onset by the appearance of the rash may be erroneous. Most patients with zoster have a history of paresthesia or some form of discomfort in the area in which the rash later appears. Perhaps this symptom should be considered the time of the onset of the disease. The failure of antibody to persist for a greater duration following zoster than after varicella makes it even more difficult to support the concept of a secondary immune response. The fall in antibody levels within 4 years or less following infection was not accompanied by any apparent change in susceptibility to infection; no second attacks of varicella or zoster were observed. Re-exposure of children with a history of chickenpox to that infection did not produce a rise in antibody levels. Complement-fixing antibodies to the agents of zoster or varicella may fall more quickly than neutralizing or other types of antibody (as occurs with the viruses of mumps, measles, poliomyelitis, and others), or levels of antibody not measurable by present techniques may be sufficient to protect from infection. A sensitive test for neutralizing antibody is needed to resolve this point. It is clear from the studies presented, however, that the CF test may be used to measure the antibody response following zoster or varicella, but it is of little value for determining susceptibility to infection.