Varicella zoster virus antibody titers after intravenous zoster immune globulin in neonates, and the safety of this preparation.
OBJECTIVE
1) To assess the safety of intravenous varicella zoster virus hyperimmune globulin G (IV-VZVIG) in neonates; 2) measure varicella zoster virus-specific IgG antibody (VZVIG) changes in newborn IV-VZVIG recipients.


METHODS
Eighteen neonatal intensive care unit (NICU) neonates with varicella exposure were given 1 ml/kg (43 International Units (IU)/kg) Varitect IV-VZVIG. Serum VZVIG titers were assayed in neonatal recipients 0, 1, 7, 14, 21, 28, and 35 d after IV-VZVIG. Also, serum samples for VZV-IgM antibody determinations were obtained at 4 wk post-infusion.


RESULTS
No varicella developed in the 18 infants. Infusion of 1 ml/kg (43 IU/kg) IV-VZVIG was generally safe. The IV-VZVIG dose resulted in seroconversion of a non-immune newborn. Five infants had low basal VZVIG titers, and two of them had a 0.6-log10 increase at 24 h post-infusion. Neonatal VZVIG titers (mean+/-SEM in log(10)) before IV-VZVIG and after by 1, 7, 14, 21, 28, and 35 d were 2.22+/-0.15, 2.17+/-0.17, 2.02+/-0.12, 0.87+/-0.2, 1.09+/-0.19, 2.33+/-0.07, and 2.16+/-0.1, respectively.


CONCLUSIONS
One ml/kg (43 IU/kg) IV-VZVIG was generally safe. Our neonatal mean VZV-immune status did not significantly increase after the 1 ml/kg (43 IU/kg) IV-VZVIG dose, although no varicella developed and it caused a VZV-specific seroconversion.
Murguía-de-Sierra
Teresa
T
Division of Neonatology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico. tmdesierra@yahoo.com
Villa-Guillén
Mónica
M
Villanueva-García
Dina
D
Molina
Antide
A
Juárez-Chávez
Alejandra
A
Leistikow
Elizabeth A
EA
D000914:Antibodies, Viral / Q000097:blood*; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006801:Humans; D007106:Immune Sera / Q000008:administration & dosage*; D007231:Infant, Newborn; D007275:Injections, Intravenous
D000914:Antibodies, Viral; D007106:Immune Sera; C030799:varicella-zoster immune globulin