Incidence, risk factors and outcome of varicella-zoster virus infection in children after haematopoietic stem cell transplantation.
We report a retrospective analysis of VZV infection after haematopoietic stem cell transplantation (HSCT) in children. Thirty-three (30%) of the total 109 children who were transplanted during a 7 year period developed post-transplant VZV infection. Twenty-four of these 33 (73%) children had VZV infection within 1 year following HSCT. The cumulative incidences of post-transplant VZV infection at 1 and 5 years were 26% and 45%, respectively. The positive and negative predictive values of pretransplant VZV serology in recipients on the development of HZ following HSCT were 39% and 88%, respectively. Pretransplant VZV seropositivity in recipients was the only risk factor for post-transplant herpes zoster (HZ) infection on multivariate analysis. All patients responded to acyclovir. The median duration of VZV infection was 5 days. Three (11%) and one (3%) children with HZ developed visceral dissemination and post-herpetic neuralgia, respectively. No mortality was directly attributed to VZV infection. VZV infection remains a major cause of morbidity in children after HSCT. Further studies are warranted to evaluate the potential use of VZV vaccine in these children. Bone Marrow Transplantation (2000) 25, 167-172.
Leung
T F
TF
Division of Haematology and Oncology, Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong.
Chik
K W
KW
Li
C K
CK
Lai
H
H
Shing
M M
MM
Chan
P K
PK
Lee
V
V
Yuen
P M
PM
D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D001804:Blood Transfusion, Autologous / Q000009:adverse effects; D002644:Chickenpox / Q000188:drug therapy* / Q000453:epidemiology* / Q000209:etiology / Q000821:virology; D019433:Chickenpox Vaccine / Q000276:immunology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006562:Herpes Zoster / Q000188:drug therapy* / Q000453:epidemiology* / Q000209:etiology / Q000821:virology; D014645:Herpesvirus 3, Human / Q000276:immunology / Q000502:physiology; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D000914:Antibodies, Viral; D000998:Antiviral Agents; D019433:Chickenpox Vaccine; D000212:Acyclovir