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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
11
pubmed:dateCreated
2005-5-18
pubmed:abstractText
Patients undergoing haemopoietic stem cell transplants (HSCT) are at high risk of varicella zoster virus (VZV) reactivation, with a significant incidence of dissemination. This study reports a retrospective analysis of 247 allogeneic HSCT recipients receiving anti-viral prophylaxis with low-dose oral aciclovir 400 mg/day, administered until immunosuppression was discontinued and the CD4(+) cell count exceeded 200/mm(3). Viral reactivation was successfully suppressed by aciclovir prophylaxis, with only one case of breakthrough infection. The cumulative incidence of zoster infection at 1 year post transplant was 2% and at 5 years 34%. In all, 64 patients discontinued prophylaxis. Zoster developed in 26 of these, giving a cumulative incidence of infection at 1 year after stopping aciclovir of 39% and at 3 years 44%. Infection occurred in a localised dermatomal distribution in 93% of cases. This supports previous findings that aciclovir prophylaxis prevents early VZV reactivation, although the long-term incidence is not affected as infection occurs once prophylaxis is discontinued. Such infection, however, is mild and localised. This study does not support the idea that use of such low-dose aciclovir regimens reduces the zoster incidence by permitting subclinical reactivation during prophylaxis, and therefore the re-establishment of protective anti-viral immunity.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
0268-3369
pubmed:author
pubmed:issnType
Print
pubmed:volume
35
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1065-9
pubmed:meshHeading
pubmed-meshheading:15806119-Acyclovir, pubmed-meshheading:15806119-Adult, pubmed-meshheading:15806119-Antiviral Agents, pubmed-meshheading:15806119-CD4-Positive T-Lymphocytes, pubmed-meshheading:15806119-Chickenpox, pubmed-meshheading:15806119-Cohort Studies, pubmed-meshheading:15806119-Hematopoietic Stem Cell Transplantation, pubmed-meshheading:15806119-Herpes Zoster, pubmed-meshheading:15806119-Herpesvirus 3, Human, pubmed-meshheading:15806119-Humans, pubmed-meshheading:15806119-Immunosuppressive Agents, pubmed-meshheading:15806119-Leukemia, pubmed-meshheading:15806119-Middle Aged, pubmed-meshheading:15806119-Postoperative Complications, pubmed-meshheading:15806119-Retrospective Studies, pubmed-meshheading:15806119-Risk Factors, pubmed-meshheading:15806119-T-Lymphocytes, pubmed-meshheading:15806119-Time Factors, pubmed-meshheading:15806119-Transplantation, Homologous, pubmed-meshheading:15806119-Transplantation Conditioning
pubmed:year
2005
pubmed:articleTitle
The effect of low-dose aciclovir on reactivation of varicella zoster virus after allogeneic haemopoietic stem cell transplantation.
pubmed:affiliation
Department of Haematology, University College London Hospitals, 98 Chenies Mews, London WC1E 6HX, UK. kirsty.thomson@uclh.org
pubmed:publicationType
Journal Article