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The yield of monitoring for HSV and VZV viremia in pediatric hematopoietic stem cell transplant patients
Author(s) -
Patrick Katharine,
Ali Muhammad,
Richardson Susan E.,
Gassas Adam,
Egeler Maarten,
Krueger Joerg,
Lowry Jane,
Allen Upton,
Schechter Tal
Publication year - 2015
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12551
Subject(s) - viremia , medicine , hematopoietic stem cell transplantation , immunology , transplantation , pediatrics , virus
Reactivation of HSV and VZV is common following HSCT . Consensus guidelines do not support the use of routine screening for viremia following HSCT in adults, but no such clear guidelines exist in pediatrics. In our center, routine practice was to screen patients weekly for HSV and VZV viremia until engraftment in autologous transplant patients and up to day +100 in allogeneic transplant patients. We conducted a retrospective study of over 500 patients to establish whether this screening identified any patients with HSV or VZV viremia who would not have been identified by clinical signs or symptoms. Over a 4.5‐yr period, routine screening identified three cases of HSV viremia and one case of VZV viremia. Two patients had persistent, unexplained fever and two patients had skin or mucosal lesions suggestive of HSV / VZV . We conclude that routine screening for HSV and VZV viremia in pediatric HSCT patients has a very low yield and that viremia can be reliably identified by targeted testing in patients with vesicular skin lesions, oral or genital ulceration, unexplained fever, neurological symptoms, or unexplained abnormal liver transaminases.