Laboratory markers of immunity to varicella-zoster virus

Clinical and subclinical reinfection with varicella-zoster virus (VZV) in healthy persons may occur despite detectable neutralizing antibodies in serum. Subclinical reinfection is not uncommon, but clinical reinfection is rare. Therefore, detectable anti-VZV antibody correlates with a subclinical course after reinfection rather than with immunity to reinfection. Cell-mediated immunity (CMI) to VZV appears to be a better indicator of immunity. Skin testing may be a simple and reliable test for CMI, but this must be further evaluated.