Post-exposure prophylaxis to prevent varicella in immunocompromised children
Summary: Background: Varicella-zoster virus (VZV) infection can cause life-threatening events in immunocompromised patients. Post-exposure prophylaxis (PEP) is required to prevent secondary VZV infection. Limited evidence is available for the use of acyclovir (ACV)/valacyclovir (VCV) as PEP. Method...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | Infection Prevention in Practice |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590088922000439 |
| _version_ | 1828412078107394048 |
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| author | Makoto Yamaguchi Nobuyuki Tetsuka Toshihiko Okumura Kazunori Haruta Takako Suzuki Yuka Torii Jun-ichi Kawada Yoshinori Ito |
| author_facet | Makoto Yamaguchi Nobuyuki Tetsuka Toshihiko Okumura Kazunori Haruta Takako Suzuki Yuka Torii Jun-ichi Kawada Yoshinori Ito |
| author_sort | Makoto Yamaguchi |
| collection | DOAJ |
| description | Summary: Background: Varicella-zoster virus (VZV) infection can cause life-threatening events in immunocompromised patients. Post-exposure prophylaxis (PEP) is required to prevent secondary VZV infection. Limited evidence is available for the use of acyclovir (ACV)/valacyclovir (VCV) as PEP. Methods: Herein, we retrospectively analyzed immunocompromised paediatric patients with significant exposure to VZV. Patients administered PEP were categorized into four groups: 1) ACV/VCV group; 2) intravenous immunoglobulin (IVIG) group; 3) ACV/VCV/IVIG group; 4) vaccine group. Results: Among 69 exposure events, 107 patients were administered PEP (91, ACV/VCV; 16, ACV/VCV/IVIG) and 10 patients did not receive PEP (non-PEP group). The index case was diagnosed based on clinical symptoms in 55 cases (79.7%). Fourteen cases (20.3%) were confirmed using direct virological diagnostic procedures. In the PEP group, only 2 patients (2.2%) developed secondary VZV infections. Additionally, 2 patients in the non-PEP group (20.0%) developed secondary VZV infection. The incidence of secondary VZV infection was significantly lower in the PEP group than in the non-PEP group (P=0.036). Among patients administered PEP, no antiviral drug-induced side effects were detected. Conclusions: Antiviral agents administered as PEP are effective and safe for preventing VZV infections in immunocompromised patients. Rapid virological diagnosis of index cases might allow efficient administration of PEP after significant exposure to VZV infection. |
| first_indexed | 2024-12-10T12:42:42Z |
| format | Article |
| id | doaj.art-b5e17da1b3554efcbcc7a4b629c52af2 |
| institution | Directory Open Access Journal |
| issn | 2590-0889 |
| language | English |
| last_indexed | 2024-12-10T12:42:42Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Infection Prevention in Practice |
| spelling | doaj.art-b5e17da1b3554efcbcc7a4b629c52af22022-12-22T01:48:30ZengElsevierInfection Prevention in Practice2590-08892022-12-0144100242Post-exposure prophylaxis to prevent varicella in immunocompromised childrenMakoto Yamaguchi0Nobuyuki Tetsuka1Toshihiko Okumura2Kazunori Haruta3Takako Suzuki4Yuka Torii5Jun-ichi Kawada6Yoshinori Ito7Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, JapanDepartment of Infectious Diseases, Nagoya University Hospital, Nagoya, JapanDepartment of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, JapanDepartment of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, JapanDepartment of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, JapanDepartment of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, JapanDepartment of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, JapanDepartment of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan; Corresponding author. Address: Yoshinori Ito, MD, PhD, Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan Tel.: +81 52-744-2294; fax: +81 52-744-2974,Summary: Background: Varicella-zoster virus (VZV) infection can cause life-threatening events in immunocompromised patients. Post-exposure prophylaxis (PEP) is required to prevent secondary VZV infection. Limited evidence is available for the use of acyclovir (ACV)/valacyclovir (VCV) as PEP. Methods: Herein, we retrospectively analyzed immunocompromised paediatric patients with significant exposure to VZV. Patients administered PEP were categorized into four groups: 1) ACV/VCV group; 2) intravenous immunoglobulin (IVIG) group; 3) ACV/VCV/IVIG group; 4) vaccine group. Results: Among 69 exposure events, 107 patients were administered PEP (91, ACV/VCV; 16, ACV/VCV/IVIG) and 10 patients did not receive PEP (non-PEP group). The index case was diagnosed based on clinical symptoms in 55 cases (79.7%). Fourteen cases (20.3%) were confirmed using direct virological diagnostic procedures. In the PEP group, only 2 patients (2.2%) developed secondary VZV infections. Additionally, 2 patients in the non-PEP group (20.0%) developed secondary VZV infection. The incidence of secondary VZV infection was significantly lower in the PEP group than in the non-PEP group (P=0.036). Among patients administered PEP, no antiviral drug-induced side effects were detected. Conclusions: Antiviral agents administered as PEP are effective and safe for preventing VZV infections in immunocompromised patients. Rapid virological diagnosis of index cases might allow efficient administration of PEP after significant exposure to VZV infection.http://www.sciencedirect.com/science/article/pii/S2590088922000439Varicella-zoster virus infectionImmunocompromised patientsPost-exposure prophylaxisAcyclovirValacyclovir |
| spellingShingle | Makoto Yamaguchi Nobuyuki Tetsuka Toshihiko Okumura Kazunori Haruta Takako Suzuki Yuka Torii Jun-ichi Kawada Yoshinori Ito Post-exposure prophylaxis to prevent varicella in immunocompromised children Infection Prevention in Practice Varicella-zoster virus infection Immunocompromised patients Post-exposure prophylaxis Acyclovir Valacyclovir |
| title | Post-exposure prophylaxis to prevent varicella in immunocompromised children |
| title_full | Post-exposure prophylaxis to prevent varicella in immunocompromised children |
| title_fullStr | Post-exposure prophylaxis to prevent varicella in immunocompromised children |
| title_full_unstemmed | Post-exposure prophylaxis to prevent varicella in immunocompromised children |
| title_short | Post-exposure prophylaxis to prevent varicella in immunocompromised children |
| title_sort | post exposure prophylaxis to prevent varicella in immunocompromised children |
| topic | Varicella-zoster virus infection Immunocompromised patients Post-exposure prophylaxis Acyclovir Valacyclovir |
| url | http://www.sciencedirect.com/science/article/pii/S2590088922000439 |
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