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.

Détails

ID Serval
serval:BIB_B8113C96F585
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
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.
Périodique
Blood
Auteur⸱e⸱s
Erard Véronique, Guthrie Katherine A., Varley Cara, Heugel Judso, Wald Anna, Flowers Mary E.D., Corey Lawrence, Boeckh Michael
ISSN
0006-4971
Statut éditorial
Publié
Date de publication
2007
Peer-reviewed
Oui
Volume
110
Numéro
8
Pages
3071-3077
Langue
anglais
Résumé
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.
Mots-clé
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
Oui
Création de la notice
02/02/2010 16:57
Dernière modification de la notice
10/02/2022 20:29
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