Varicella Zoster Virus Infections

Ho, Dora Y.; Arvin, Ann M.

doi:10.1002/9781118416426.ch89

Cited by 8 publications

(10 citation statements)

References 240 publications

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“…5 Despite treatment, VZV disease leads to postherpetic neuralgia (PHN) in 25% to 68% (median 32% [6][7][8] ) of HCT recipients who develop dermatomal zoster. 1 Four randomized [9][10][11][12] and 1 retrospective study 13 have demonstrated that the frequency of VZV disease is reduced during prophylaxis with acyclovir post allo-HCT; however, a rebound effect is observed in prophylaxed patients, who frequently develop VZV disease after discontinuation of acyclovir. As a result, the cumulative incidence of VZV disease is similar to the nonprophylaxed groups.…”

Section: Introductionmentioning

confidence: 99%

Zoster prophylaxis after allogeneic hematopoietic cell transplantation using acyclovir/valacyclovir followed by vaccination

et al. 2016

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Key Points• Two years of antiviral prophylaxis and VZV vaccination reduce the incidence of VZV disease and nearly eliminate post-herpetic neuralgia. Patients who completed the old strategy had a significantly higher cumulative incidence of VZV disease (33% vs 17% at 5 years, P # .01) and PHN (8% vs 0% at 5 years, P 5 .02). In conclusion, VZV prophylaxis with 2 years of acyclovir/valacyclovir followed by vaccination appears to result in a low incidence of VZV disease and may eliminate PHN.

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Section: Introductionmentioning

confidence: 99%

Zoster prophylaxis after allogeneic hematopoietic cell transplantation using acyclovir/valacyclovir followed by vaccination

et al. 2016

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“…The rate of VZV reactivation post-HCT has ranged between 17% and 63% and recipients of cord blood and TCD HCT are at higher risk for VZV infection. 9…”

Section: Discussionmentioning

confidence: 99%

Efficacy of brincidofovir as prophylaxis against HSV and VZV in hematopoietic cell transplant recipients

Lee

Neofytos

Kim

et al. 2018

Transplant Infectious Dis

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Allogeneic hematopoietic cell transplant (HCT) recipients are at risk for herpes simplex virus (HSV) and varicella-zoster virus (VZV) infections. Routine prophylaxis with acyclovir is recommended during periods of immunosuppression. Brincidofovir (BCV, CMX001), a lipid conjugate of cidofovir, has shown in vitro activity against HSV/VZV, but has not been formally studied for HSV/VZV prophylaxis. We report our clinical experience of BCV for HSV/VZV prophylaxis in HCT recipients. This was a retrospective review of 30 hematopoietic cell transplant (HCT) recipients between 8/2010 and 8/2015 who received BCV doses not exceeding 200 mg/week for adults/adolescents and 4 mg/kg/week for pediatric (<12 years) patients, for ≥14 days BCV without concomitant acyclovir under clinical trials or single patient use. HSV/VZV cases during BCV treatment were confirmed by viral culture or PCR and clinical symptoms. Of 30 patients who met the inclusion criteria, 27 (90%) patients were adults and 22 (73%) patients received T-cell depleted HCT. The most common indications for BCV were cytomegalovirus in 12 patients (40%) and adenovirus in 11 patients (37%). One patient was treated for acyclovir-resistant HSV and one for disseminated VZV. There were two breakthrough cases of HSV infection during 2170 patient-days. There were no cases of breakthrough VZV infection. The overall rate of breakthrough HSV infection was 1.0 per 1000 patient-days, without any breakthrough VZV infections. Our study provides the only available-albeit limited-evidence on the potential efficacy of BCV for HSV/VZV prophylaxis in HCT patients. Additional studies are needed to further assess the efficacy and safety of BCV in the setting.

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“…Allogeneic graft recipients received prophylaxis against acute GVHD with immunosuppressive drugs, usually cyclosporine or tacrolimus plus methotrexate or mycophenolate mofetil 9 . Prophylaxis for infections included acyclovir to prevent herpes simplex virus and varicella zoster infection, trimethoprim/ sulfamethoxazole to prevent Pneumocystic jivecii infection, oral fluconazole or itraconazole for prophylaxis of fungal infection, and pre-emptive ganciclovir for cytomegalovirus disease among viremic patients 10 - 14 . Prophylactic oral ursodiol was given routinely to prevent cholestatic liver injury 15 .…”

Section: Methodsmentioning

confidence: 99%

Markers of coagulation activation and acute kidney injury in patients after hematopoietic cell transplantation

Hingorani

Seidel

Pao

et al. 2015

Bone Marrow Transplant

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Acute kidney injury (AKI) is common after hematopoietic cell transplant (HCT). The etiology of AKI is unknown because biopsies are rarely performed. The pathophysiology of injury is inferred from clinical data. Thrombotic microangiopathy (TMA) is often invoked as the cause of renal injury. Patients > 2 years undergoing their first HCT at Fred Hutchinson Cancer Research Center (FHCRC) participated in this study. We prospectively measured plasma markers of coagulation activation, (PAI-1 and tPA) and fibrinolyis (D-dimer) weekly in 149 patients during the first 100 days post-transplant. Cox proportional hazards modeling was used to determine associations between these markers and AKI (doubling of baseline serum creatinine). Kruskal-Wallis test was used to determine associations between day 100 urinary albumin to creatinine ratios (ACR) and these markers. Thirty one percent of patients developed AKI. Though elevations in these markers occurred frequently, neither PAI-1 nor tPA were associated with development of AKI. D-dimer was associated with a slightly increased risk of AKI (RR=1.76; p-value 0.04). None of these markers were associated with micro- or macroalbuminuria at day 100. The lack of an association with AKI suggests that endothelial injury in the form of TMA is not a common cause of AKI early after transplant.

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Varicella Zoster Virus Infections

Cited by 8 publications

References 240 publications

Zoster prophylaxis after allogeneic hematopoietic cell transplantation using acyclovir/valacyclovir followed by vaccination

Zoster prophylaxis after allogeneic hematopoietic cell transplantation using acyclovir/valacyclovir followed by vaccination

Efficacy of brincidofovir as prophylaxis against HSV and VZV in hematopoietic cell transplant recipients

Markers of coagulation activation and acute kidney injury in patients after hematopoietic cell transplantation

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