Low Sensitivity of Commercial Assays for Varicella-Zoster Virus Seropositivity in Pediatric Patients With Inflammatory Bowel Disease.

Caldera, Freddy; Hayney, Mary S; Strople, Jennifer A; Kastl, Arthur J; Adler, Jeremy; Boccieri, Margie; Zhang, Xian; Long, Millie D et al. · Am J Gastroenterol · 2026

cross_sectional · Level IV

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Abstract

Pediatric inflammatory bowel disease (IBD) guidelines recommend assessing varicella zoster virus (VZV) immunity before immune suppression. We evaluated the sensitivity of the commercial VZV assay relative to the more sensitive glycoprotein (GP) IgG ELISA. We evaluated VZV immunity among 176 children with IBD using both commercial and GP ELISA tests. Using GP ELISA, 90% showed VZV immunity vs 69% on commercial assays. Commercial test sensitivity was 77% with 69% false-negative rate and 32% negative predictive value. As commercial VZV assays frequently fail to detect existing immunity in children with IBD, vaccination history should be used to assess VZV immunity.

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