One-year acyclovir prophylaxis for preventing varicella-zoster virus disease after hematopoietic cell transplantation: no evidence of rebound varicella-zoster virus disease after drug discontinuation.

Details

Serval ID
serval:BIB_B8113C96F585
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
One-year acyclovir prophylaxis for preventing varicella-zoster virus disease after hematopoietic cell transplantation: no evidence of rebound varicella-zoster virus disease after drug discontinuation.
Journal
Blood
Author(s)
Erard Véronique, Guthrie Katherine A., Varley Cara, Heugel Judso, Wald Anna, Flowers Mary E.D., Corey Lawrence, Boeckh Michael
ISSN
0006-4971
Publication state
Published
Issued date
2007
Peer-reviewed
Oui
Volume
110
Number
8
Pages
3071-3077
Language
english
Abstract
No consensus exists on whether acyclovir prophylaxis should be given for varicella-zoster virus (VZV) prophylaxis after hematopoietic cell transplantation because of the concern of "rebound" VZV disease after discontinuation of prophylaxis. To determine whether rebound VZV disease is an important clinical problem and whether prolonging prophylaxis beyond 1 year is beneficial, we examined 3 sequential cohorts receiving acyclovir from day of transplantation until engraftment for prevention of herpes simplex virus reactivation (n = 932); acyclovir or valacyclovir 1 year (n = 1117); or acyclovir/valacyclovir for at least 1 year or longer if patients remained on immunosuppressive drugs (n = 586). In multivariable statistical models, prophylaxis given for 1 year significantly reduced VZV disease (P < .001) without evidence of rebound VZV disease. Continuation of prophylaxis beyond 1 year in allogeneic recipients who remained on immunosuppressive drugs led to a further reduction in VZV disease (P = .01) but VZV disease developed in 6.1% during the second year while receiving this strategy. In conclusion, acyclovir/valacyclovir prophylaxis given for 1 year led to a persistent benefit after drug discontinuation and no evidence of a rebound effect. To effectively prevent VZV disease in long-term hematopoietic cell transplantation survivors, additional approaches such as vaccination will probably be required.
Keywords
Acyclovir/administration & dosage, Adolescent, Adult, Aged, Antiviral Agents/administration & dosage, Child, Child, Preschool, Female, Hematopoietic Stem Cell Transplantation/adverse effects, Herpes Zoster/epidemiology, Herpes Zoster/immunology, Humans, Immunocompromised Host, Infant, Male, Middle Aged, Simplexvirus/drug effects, Simplexvirus/physiology, Time Factors, Virus Activation/drug effects
Pubmed
Web of science
Open Access
Yes
Create date
02/02/2010 15:57
Last modification date
20/08/2019 15:26
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