{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:05:23Z","timestamp":1785524723869,"version":"3.56.0"},"reference-count":78,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Varicella zoster virus (VZV) infection is typically mild in children but may result in severe complications in some cases. Environmental lead exposure is known to impair immune function; however, its relationship with VZV\u2010specific humoral immunity has not been well characterized. We analyzed data from 7,938 participants aged 6\u201319 years from the National Health and Nutrition Examination Survey (NHANES) 1999\u20132004 to examine the association between blood lead levels (BLL) and VZV IgG concentrations. Multivariable linear regression models were used to evaluate this association, and dose\u2013response relationships were explored to assess potential nonlinearity. After adjustment for potential confounders, higher BLL was significantly associated with lower VZV IgG levels (\u03b2 = \u22120.24, 95% CI: \u22120.43, \u22120.05,\n                    <jats:italic>p<\/jats:italic>\n                    = 0.013), with no evidence of effect modification by demographic or metabolic factors. A nonlinear dose\u2010response relationship was identified, with a stronger inverse association observed below the inflection point of 1 \u03bcg\/dL (\u03b2 = \u22121.23, 95% CI: \u22122.22, \u22120.24) compared with levels above this threshold (\u03b2 = \u22120.14, 95% CI: \u22120.35, 0.08); the log\u2010likelihood ratio test confirmed significant nonlinearity (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.045). These findings suggest that even low\u2010level lead exposure may be associated with reduced VZV IgG concentrations among U.S. children and adolescents, highlighting potential immunological effects of environmental lead exposure.\n                  <\/jats:p>","DOI":"10.1002\/jmv.70835","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T10:07:12Z","timestamp":1770977232000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lead Exposure and Humoral Immunity to Varicella Zoster Virus in the United States: A Nationwide Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"98","author":[{"given":"Xin","family":"Li","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Jinan University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinzhen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pathology Yuebei People's Hospital Affiliated to Shantou University Medical College Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Tan","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Jinan University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"issue":"5","key":"e_1_2_11_2_1","first-page":"1","article-title":"Prevention of Herpes Zoster: Recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"57","author":"Harpaz R.","year":"2008","journal-title":"MMWR. 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