COMPARISON OF TECHNIQUES AND EVALUATION OF 3 COMMERCIAL MONOCLONAL-ANTIBODIES FOR LABORATORY DIAGNOSIS OF VARICELLA-ZOSTER VIRUS IN MUCOCUTANEOUS SPECIMENS

A comparison of direct antigen detection in cell scrapings,vith cultur e techniques (tube culture and shell vial method) for diagnosis of var icella-zoster virus (VZV) mucocutaneous infections was done in paralle l in two groups of specimens. A total of 100 specimens were from patie nts with clinical diagnosis of VZV infection (group 1), and 69 were fr om patients with no suspicion of VZV infection (group 2) but mainly wi th herpes simplex virus infections. In addition, three commercially av ailable monoclonal antibodies (Whittaker, Biosoft Clone 2013, and Orth o 3B3) directed against VZV antigens were evaluated in parallel in the last 87 group 1 specimens. Overall, 80% of the group 1 specimens were confirmed positive by direct detection, in comparison with 56% positi ve by tube culture and/or shell vial. None of the group 2 specimens we re positive for VZV by any of the methods, and none of the monoclonal antibodies assayed reacted with any herpes simplex virus stock strains . Antiviral therapy and the length of evolution time of lesions affect ed negatively the performance of all laboratory methods, but to a less er extent in direct-detection techniques than in culture techniques. T he Whittaker and Biosoft reagents (indirect immunofluorescence assay) showed statistically significant differences in sensitivity with respe ct to the Ortho antibody (P = 0.002 and P = 0.039, respectively; two-t ailed binomial test). Direct antigen detection is a rapid, easy-to-per form, sensitive, and specific technique and appears to be the method o f choice for laboratory confirmation of VZV mucocutaneous infections.