Postexposure Prophylaxis Against Varicella Zoster Virus Infection Among Hematopoietic Stem Cell Transplant Recipients

Bone Marrow Transplant Service, Memorial Sloan-Kettering Cancer Center, New York, New York, United States
Biology of Blood and Marrow Transplantation (Impact Factor: 3.4). 11/2006; 12(10):1096-7. DOI: 10.1016/j.bbmt.2006.06.005
Source: PubMed

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    • "Besides, vaccination of VZV-seronegative individuals who may be in contact with the patients during transplantation should be done [25]. Zoster immune globulin (ZIG) and varicella-zoster immune globulin (VZIG) are passive antibody prophylaxis in seronegative recipients after exposure to varicella [113]. Acyclovir and valacyclovir prophylaxis were proven effective in several trials [9,114-117]. "
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    ABSTRACT: Viral infections are important causes of morbidity and mortality after allogeneic stem cell hematopoietic transplantation (allo-HSCT). Although most viral infections present with asymptomatic or subclinical manifestations, viruses may result in fatal complications in severe immunocompromised recipients. Reactivation of latent viruses, such as herpesviruses, is frequent during the immunosuppression that occurs with allo-HSCT. Viruses acquired from community, such as the respiratory and gastrointestinal viruses, are also important pathogens of post-transplant viral diseases. Currently, molecular diagnostic methods have replaced or supplemented traditional methods, such as viral culture and antigen detection, in diagnosis of viral infections. The utilization of polymerase chain reaction facilitates the early diagnosis. In view of lacking efficacious agents for treatment of viral diseases, prevention of viral infections is extremely valuable. Application of prophylactic strategies including preemptive therapy reduces viral infections and diseases. Adoptive cellular therapy for restoring virus-specific immunity is a promising method in the treatment of viral diseases.
    Journal of Hematology & Oncology 12/2013; 6(1):94. DOI:10.1186/1756-8722-6-94 · 4.81 Impact Factor
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    ABSTRACT: Antiviral agents play a key role in the prevention and treatment of varicella zoster virus (VZV) disease in immunosuppressed patients. Randomized trials show that aciclovir is effective in preventing VZV reactivation disease; however, no consensus exists on dose, duration and patient population for its use. The recent shortage of VZV-specific immunoglobulin has generated renewed interest in the use of antiviral agents as post-exposure prophylaxis. The use of antiviral agents for post-exposure prophylaxis is not supported by randomized trials, but uncontrolled experience suggests that it might be a reasonable alternative if varicella-specific immunoglobulin is not available. Current evidence on the use of antiviral agents in the prevention of reactivation disease and management of exposure to VZV is discussed.
    Herpes: the journal of the IHMF 12/2006; 13(3):60-5.
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    ABSTRACT: In severely immunocompromised patients, the diagnosis of viral infections relies on PCR/RT-PCR based methods. The availability of these modern diagnostic tools facilitates timely diagnosis and contributes to our increasing knowledge of the epidemiology and clinical spectrum of common and emerging viral pathogens in this highly susceptible population. Viral infections may result in life threatening disease in paediatric cancer patients after stem cell transplantation and also during conventional chemotherapy. Often, clinical symptoms are a consequence of endogenous reactivation of latent viral infection. Many of these viruses are easily transmitted between patients, relatives and health care workers. As prolonged symptomatic and asymptomatic viral shedding is a common feature in paediatric cancer patients, it is necessary to implement strategies for the prevention and control of these communicable pathogens in the hospital setting and in the outpatient clinic. Although no randomised controlled studies on paediatric cancer patients are available, physicians should be aware of potential treatment options since early treatment may prevent a complicated or fatal outcome and shorten the period of contagiosity.
    Archives of Disease in Childhood 07/2008; 93(10):880-9. DOI:10.1136/adc.2007.132225 · 2.90 Impact Factor
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