Acyclovir Prevents Dissemination of Varicella in Immunocompromised Children

Abstract

Fifty immunocompromised children with varicella who exhibited no signs of dissemination were treated with intravenous acyclovir or placebo in a double-blind, randomized study. Twelve of 25 placebo recipients were withdrawn from treatment because of their deteriorating condition and were given open acyclovir therapy; only one of 25 recipients of acyclovir was similarly withdrawn (P less than .001). Among those patients who did not receive open treatment, acyclovir significantly reduced time to full crusting (P = .01). Overall, acyclovir, as judged by the physician, significantly improved the patients' condition.

Incidence and consequences of varicella in children treated for cancer in Guatemala

“…[9][10][11] Previous studies have reported the risk of disseminated infection in these patients, in the absence of prophylaxis or treatment with acyclovir, to be approximately 32%-50%. [12] Inclusion of the liveattenuated varicella vaccine in the routine childhood…”

A case for varicella vaccination in the immunosuppressed

“…Irrespective of having received postexposure prophylaxis with VZIG or not, the patient should be monitored closely for the development of any relevant symptoms. At the first sign of illness, prompt high-dose intravenous aciclovir is essential and decreases varicella-related complications and mortality (as demonstrated in HIV patients)7 and reduces clinical deterioration (data derived from children receiving chemotherapy) 8. Despite prophylaxis with VZIG and prompt treatment with aciclovir, varicella may still be fatal 9…”

Solid-Phase Assay for the Detection of Varicella Zoster Virus

“…In most cases, the characteristic features of the vesicular varicella rash establish the clinical diag nosis; however, the most common application of laboratory testing for varicella is to confirm fatal, severe or atypical illness that would require prompt intravenous treatment, such as acyclovir or immunoglobulin [2,6]. In this cases, VZV can be identified in clinical materials by: n Viral culture; n Serological methods, including ELISA tests and immunoprecipitation;…”