Postexposure Prophylaxis Against Varicella-Zoster Virus Infection Among Recipients of Hematopoietic Stem Cell Transplant: Unresolved Issues

Abstract

"Postexposure prophylaxis against varicella-zoster virus infection among recipients of hematopoietic stem cell transplant: Unresolved issues

Management of HSV, VZV and EBV infections in patients with hematological malignancies and after SCT: guidelines from the Second European Conference on Infections in Leukemia

“…Reports of 57 immunocompromised patients with reinfection were summarized recently. 114 It seems that the rate of reinfection is very low, although not insignificant. Arguments for the use of passive immunization for VZVseropositive leukemia and SCT recipients include the theoretical potential for supplementing immunity against VZV.…”

“…Although the risk for VZV-seropositive patients is low, it is nevertheless not entirely insignificant. 114 This is especially the case for those who have been immunized against VZV because the immune response to the vaccine is lower than that after chicken pox. 115 Patients should avoid contact with patients with varicella or disseminated zoster, who should be placed under airborne and contact isolation until all lesions are crusted (BIII).…”

Varicella at “Casa Garrahan”, 2008-2013. Assessment of post-exposure prophylaxis measures

“…regardless of their history of varicella given the risk of reinfection reported in this group. 7 The Department of Epidemiological Control and Infectology of Hospital "Prof. Dr. J. P. Garrahan" documented the prophylaxis measure implemented in each case and was in charge of follow-up at 30 days of exposure to the index case.…”

Human Herpesviruses in Hematologic Diseases

“…Arguments for the use of passive immunisation for VZVseropositive leukemia and HSCT recipients include the theoretical potential for supplementing immunity against VZV. The arguments against include scarity of VZIG and ZIG, their cost, the low incidence of reinfection, lack of proven efficiency in VZVseropositive recipients, and the possible adverse effect and discomfort associated with passive immunization (Weinstock et al, 2004).…”

“…This regimen is highly effective, safe, inexpensive, and does not appear to interfere with VZV specific immune reconstruction (Boeckh et al, 2006). At present, acyclovir prophylaxis is not a universal practice in all transplant centers, because the prompt initiation of acyclovir for the treatment of recurrent VZV infections is effective (Weinstock et al, 2004) and long-term use can be associated with emergence of drug-resistant VZV mutants.…”