Varicella immunity in inflammatory bowel disease

Area of Science:

• Immunology
• Pediatrics
• Gastroenterology

Background:

• Varicella zoster poses a severe risk to immunocompromised individuals, including those on steroids.
• Inflammatory Bowel Disease (IBD) management often involves immunosuppression, increasing VZV susceptibility.
• Assessing pre-existing varicella immunity in newly diagnosed IBD patients is crucial.

Purpose of the Study:

• To determine the prevalence of varicella zoster antibodies in newly diagnosed IBD patients.
• To evaluate the proportion of IBD patients protected against varicella by prior infection or vaccination.
• To inform screening and vaccination strategies for IBD management.

Main Methods:

• Retrospective chart review of IBD patients diagnosed between January 1, 2005, and December 31, 2009.
• Analysis included patient demographics, IBD type, and history of varicella disease or vaccination.
• Assessment of measurable varicella antibody titers.

Main Results:

• 163 new IBD diagnoses were identified; 57% were male, with a mean age of 12.
• Crohn's disease accounted for 62%, ulcerative colitis for 33%, and indeterminate colitis for 5%.
• Only 77% of patients had measurable varicella antibody titers, indicating a significant lack of immunity.

Conclusions:

• A substantial number of pediatric and adolescent IBD patients lack varicella immunity at diagnosis.
• Routine screening for varicella immune status in IBD patients is recommended.
• Vaccination prior to immunosuppression is vital, but challenging once treatment commences.