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Onset and complications of varicella zoster reactivation in the autologous hematopoietic cell transplant population
Author(s) -
Rogers J.E.,
Cumpston A.,
Newton M.,
Craig M.
Publication year - 2011
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2011.00655.x
Subject(s) - medicine , postherpetic neuralgia , population , varicella zoster virus , complication , surgery , hematopoietic stem cell transplantation , transplantation , hematopoietic cell , shingles , incidence (geometry) , pediatrics , virus , immunology , anesthesia , stem cell , haematopoiesis , physics , environmental health , neuropathic pain , optics , biology , genetics
J.E. Rogers, A. Cumpston, M. Newton, M. Craig. Onset and complications of varicella zoster reactivation in the autologous hematopoietic cell transplant population.
Transpl Infect Dis 2011: 13: 480–484. All rights reserved Background. Varicella zoster virus (VZV) infections are a common complication in patients receiving autologous or allogeneic hematopoietic cell transplant (HCT). Recent guideline revisions suggest extending VZV prophylaxis to 1 year after autologous HCT. We retrospectively evaluated reactivation at our center, before implementation of extended acyclovir prophylaxis, to determine onset and outcome in the autologous HCT population. Methods. Inclusion criteria consisted of adult patients who received an autologous HCT with documentation for at least 1 year post transplant. Those excluded from review were patients who received acyclovir prophylaxis for >30 days post transplant or subsequently received an allogeneic transplant within 1 year. For patients in whom reactivation occurred, the severity of infection, the timing of onset, treatment of the reactivation, and any complications were recorded. Results. In the final analysis, 56 patients were assessed. Reactivation of zoster occurred in 16% of recipients with a median onset of 4.5 months post transplant. Complications that were observed include postherpetic neuralgia, severe pain, scarring, and motor weakness. Two patients required hospitalization for treatment, with 1 patient requiring 6 months of rehabilitation for motor weakness following the infection. Conclusions. Our study revealed a 16% incidence of VZV reactivation in our autologous HCT population. The onset of these occurrences ranged from 2 to 10 months post transplant, with significant VZV‐associated complications. We consider VZV reactivation a serious concern in the autologous transplant setting, requiring extended prophylaxis.