The Varicella Zoster Virus Immunoglobulin G and the Varicella Zoster Virus Infection in Children with Cancer Under Chemotherapy.

The varicella zoster virus (VZV) is known to be fatal especially for immunocompromised patients receiving chemotherapy for childhood cancer. So we investigated the change of varicella zoster virus immunoglobulin G (VZV IgG) before and during chemotherapy in patients who suffered from chicken pox (CP) or herpes zoster (HZ) to find the relationship between them.

We reviewed the transition of VZV IgG through medical records in children with cancer who experienced CP or HS during chemotherapy from 1998 to 2008 in Kyungpook National University Hospital, Daegu, South Korea.

We checked VZV IgG not only when they were diagnosed as cancer but also when they were receiving chemotherapy for 66 patients (VZV IgG (+) : VZV IgG (-) = 40 : 26). Among initial VZV IgG positive group, 28 patients showed sustained positive IgG during chemotherapy, and 6 patients underwent the disease (CP : HZ = 1 : 5). On the other hand, 12 patients showed negative IgG while chemotherapy and 8 patients experienced the disease (CP : HZ = 4 : 4). The seronegative group after chemotherapy showed higher morbidity of CP or HZ compare to seropositive group (p=0.011). In the case of VZV IgG negative group at diagnosis, 8 patients presented seroconsersion to positive IgG and they had no disease of VZV. Among them, 18 patients who showed still negative IgG developed 4 (CP : HZ = 2 : 2). All together, the seronegative group revealed the tendency of higher morbidity (p=0.034). We treated them using intravenous acyclovir, and no mortality was observed.

Because of higher frequency of CP or HZ in VZV IgG negative group during chemotherapy, it is important to decide when and for whom to carry out VZV vaccination during chemotherapy through regular VZV IgG checking.

No relevant conflicts of interest to declare.