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Aciclovir and Varicella-zoster-immunoglobulin in solid-organ transplant recipients

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Abstract

Clear recommendations for the management of acute varicella-zoster virus (VZV) infections for cases of significant exposure and the use of prophylactic drugs after solid-organ transplantation are missing due to the lack of evidence by prospective studies. Heterogeneity in patient groups, patient numbers, age groups, immunosuppressive regimens, timing, and dosage of aciclovir and/or varicella-zoster immunoglobulin (VZIG), pre-transplant vaccination or VZV wild-type infection and inconsistency of data make comparability of different studies impossible. Although the benefit of aciclovir and/or VZIG is uncertain in immunosuppressed children, prospective controlled double-blind studies are not feasible for ethical considerations as fatal cases with disseminating varicella disease are well known in these patient groups despite the use of aciclovir and/or VZIG, whereas severe side-effects of these drugs are rare. However, a reporting bias is likely as mainly severe or fatal cases might have been predominantly published or cases of successfully used aciclovir and/or VZIG in mild cases or in cases of breakthrough infections after vaccination. As neither VZIG prophylaxis nor treatment with intravenous aciclovir offers complete protection against severe VZV infection to immunosuppressed pediatric solid-organ transplant recipients, high priority should be given to vaccination against VZV prior to transplantation, and, most importantly, in their close contact persons. Clinical observations suggest that only assessment of humoral immunity together with cellular immunity may allow predication about protection in exposed patients.

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References

  1. Slifkin M, Doron S, Snydham DR (2004) Viral prophylaxis in organ transplant patients. Drugs 64:2763–2792

    Article  PubMed  CAS  Google Scholar 

  2. Heininger U, Seward JF (2006) Varicella. Lancet 368:1365–1376

    Article  PubMed  Google Scholar 

  3. Lynfield R, Herrin JT, Rubin RH (1992) Varicella in pediatric renal-transplant recipients. Pediatrics 90:216–220

    PubMed  CAS  Google Scholar 

  4. Sauerbrei A, Farber I, Brandstadt A, Schake M, Wutzler P (2004) Immunofluorescence test for sensitive detection of varicella-zoster virus-specific IgG: an alternative to fluorescent antibody to membrane antigen test. J Virol Methods 119:25–30

    Article  PubMed  CAS  Google Scholar 

  5. White CJ, Kuter BJ, Ngai A, Hildebrand CS, Isganitis KL, Patterson CM, Capra A, Miller WJ, Krah DL, Provost PJ (1992) Modified cases of chickenpox after varicella vaccination: correlation of protection with antibody disease. Pediatr Infect Dis J 11:19–23

    Article  PubMed  CAS  Google Scholar 

  6. Li S, Chan IS, Matthews H, Heyse JF, Chan CY, Kuter BJ, Kaplan KM, Vessey SJ, Sadoff JC (2002) Inverse relationship between six-week postvaccination varicella antibody response to vaccine and likelihood of long-term breakthrough infection. Pediatr Infect Dis J 21:338–342

    Google Scholar 

  7. Feldhoff CM, Balfour HH, Simmons RL, Najarian JS, Maurer SM (1981) Varicella in children with renal transplants. J Pediatr 98:25–31

    Article  PubMed  CAS  Google Scholar 

  8. Rothwell WS, Gloor JM, Morgenstern BZ, Milliner DS (1999) Disseminated varicella infection in pediatric renal transplant recipients treated with mycophenolate mofetil. Transplantation 68:158–161

    Article  PubMed  CAS  Google Scholar 

  9. Laube GF, Berger C, Goetschel P, Leumann E, Neuhaus TJ (2002) Immunization in children with chronic renal failure. Pediatr Nephrol 17:638–642

    Article  PubMed  Google Scholar 

  10. Breuer J, Schmid DS, Gerson AA (2008) Use and limitations of varicella-zoster virus-specific serological testing to evaluate breakthrough disease in vaccinees and to screen for susceptibility to varicella. J Infect Dis 197:S147–S151

    Article  PubMed  Google Scholar 

  11. Feldman S, Hughes WT, Daniel CB (1975) Varicella in children with cancer: seventy-seven cases. Pediatrics 56:388–397

    PubMed  CAS  Google Scholar 

  12. Izurieta HS, Strebel PM, Blake PA (1997) Postlicensure effectiveness of varicella vaccine during an outbreak in a child care center. JAMA 278:1495–1499

    Article  PubMed  CAS  Google Scholar 

  13. Smith JG, Liu X, Kaufhold RM, Clair J, Caulfield MJ (2001) Development and validation of a gamma interferon ELISPOT assay for quantitation of cellular immune responses to varicella-zoster virus. Clin Diagn Lab Immunol 8:871–879

    PubMed  CAS  Google Scholar 

  14. Vossen MT, Gent MR, Weel JF, de Jong MD, van Lier RA, Kuijpers TW (2004) Development of virus-specific CD4+ T cells on reexposure to varicella-zoster virus. J Infect Dis 190:72–82

    Article  PubMed  Google Scholar 

  15. Weinberg A, Horslen SP, Kaufman SS, Jesser R, Devoll-Zabrocki A, Fleckten BL, Kochanowicz S, Seipel KR, Levin MJ (2006) Safety and immunogenicity of varicella-zoster virus vaccine in pediatric liver and intestine transplant recipients. Am J Transplant 6:565–568

    Article  PubMed  CAS  Google Scholar 

  16. Starko KM, Ray CG, Dominguez LB, Stromberg WL, Woodall DF (1980) Reyes syndrome and salicylate use. Pediatrics 66:859–864

    PubMed  CAS  Google Scholar 

  17. Lesko SM, O'Brien KL, Schwartz B, Vezina R, Mitchell AA (2001) Invasive group A streptococcal infection and nonsteroidal antiinflammatory drug use among children with primary varicella. Pediatrics 107:1108–1115

    Article  PubMed  CAS  Google Scholar 

  18. Zerr DM, Alexander ER, Duchin JS, Koutsky LA, Rubens CE (1999) A case-control study of necrotizing fasciitis during primary varicella. Pediatrics 103:783–790

    Article  PubMed  CAS  Google Scholar 

  19. Academy of Pediatrics Committee on Infectious Diseases (1993) The use of oral aciclovir in otherwise healthy children with varicella. Pediatrics 91:858

    Google Scholar 

  20. Balfour HH, Kelly JM, Suarez CS, Heussner RC, Englund JA, Crane DD, McGuirt PV, Clemmer AF, Aeppli DM (1990) Aciclovir treatment of varicella in otherwise healthy children. J Pediatr 116:633–639

    Article  PubMed  Google Scholar 

  21. Enright AM, Prober CG (2003) Antiviral therapy in children with varicella zoster virus and herpes simplex virus infections. Herpes 10:32–37

    PubMed  Google Scholar 

  22. Shepp DH, Dandliker PS, Meyers JD (1986) Treatment of varicella zoster virus-infection in severely immunocompromised patients - A randomized comparison of aciclovir and vidarabine. N Engl J Med 314:208–212

    Article  PubMed  CAS  Google Scholar 

  23. Fishman JA, Rubin RH (1998) Infection in organ-transplant recipients - Reply. N Engl J Med 339:1246

    Article  Google Scholar 

  24. Zeng L, Nath CE, Blair EY, Shaw PJ, Stephen K, Earl JW, Coakley JC, McLAchlan AJ (2009) Population pharmacokinetics of acyclovir in children and young people with malignancy after administration of intravenous acyclovir or oral valacyclovir. Antimicrob Agents Chemother 53:2918–2927

    Article  PubMed  CAS  Google Scholar 

  25. Brigden D, Bye A, Fowle AS, Rogers H (1981) Human pharmacokinetics of acyclovir (an antiviral agent) following rapid intravenous injection. J Antimicrob Chemother 7:399–404

    Article  PubMed  CAS  Google Scholar 

  26. Dunkle LM, Arvin AM, Whitley RJ, Rotbart HA, Feder HM Jr, Feldman S, Gershon AA, Levy ML, Hayden GF, McGuirt PV (1991) A controlled trial of aciclovir for chickenpox in normal children. N Engl J Med 325:1539–1544

    Article  PubMed  CAS  Google Scholar 

  27. Yoshikawa T, Suga S, Kozawa T, Kawaguchi S, Asano Y (1998) Persistence of protective immunity after postexposure prophylaxis of varicella with oral aciclovir in the family setting. Arch Dis Child 78:61–63

    Article  PubMed  CAS  Google Scholar 

  28. Huang YC, Lin TY, Chiu CH (1995) Aciclovir prophylaxis of varicella after household exposure. Pediatr Infect Dis J 14:152–154

    Article  PubMed  CAS  Google Scholar 

  29. Asano Y, Yoshikawa T, Suga S, Kobayashi I, Nakashima T, Yazaki T, Ozaki T, Yamada A, Imanishi J (1993) Postexposure prophylaxis of varicella in family contact by oral aciclovir. Pediatrics 92:219–222

    PubMed  CAS  Google Scholar 

  30. Beutner KR, Friedman DJ, Forszpaniak C, Andersen PL, Wood MJ (1995) Valaciclovir compared with aciclovir for improved therapy for herpes zoster in immunocompetent adults. Antimicrob Agents Chemother 39:1546–1553

    PubMed  CAS  Google Scholar 

  31. Faulds D, Heel RC (1990) Ganciclovir - A review of its antiviral activity, pharmacokinetic properties and therapeutic efficacy in cytomegalovirus infections. Drugs 39:597–638

    Article  PubMed  CAS  Google Scholar 

  32. McGregor RS, Zitelli BJ, Urbach AH, Malatack JJ, Gartner JC (1989) Varicella in pediatric orthotopic liver-transplant recipients. Pediatrics 83:256–261

    PubMed  CAS  Google Scholar 

  33. Van Der Zwet EC, Vandenbroucke-Grauls CM, van Elburg RM, Cranedonk A, Zaaijer HL (2002) Neonatal antibody titers against varicella-zoster virus in relation to gestational age, birth weight, and maternal titer. Pediatrics 109:79–85

    Article  Google Scholar 

  34. Zaia JA, Levin MJ, Preblud SR, Leszczynski J, Wright GG, Ellis RJ, Curtis AC, Valerio MA, LeGore J (1983) Evaluation of varicella-zoster immune globulin - protection of immunosuppressed children after household exposure to varicella. J Infect Dis 147:737–743

    Article  PubMed  CAS  Google Scholar 

  35. Arbeter AM, Granowetter L, Starr SE, Lange B, Wimmer R, Plotkin SA (1990) Immunization of children with acute lymphoblastic-leukemia with live attenuated varicella vaccine without complete suspension of chemotherapy. Pediatrics 85:338–344

    PubMed  CAS  Google Scholar 

  36. Brunell PA, Shehab Z, Geiser C, Waugh JE (1982) Administration of live varicella vaccine to children with leukemia. Lancet 2:1069–1073

    Article  PubMed  CAS  Google Scholar 

  37. Levin MJ, Gershon AA, Weinberg A, Blanchard S, Nowak B, Palumbo B, Chan CY (2001) Immunization of HIV-infected children with varicella vaccine. J Pediatr 139:305–310

    Article  PubMed  CAS  Google Scholar 

  38. Rivest P, Bedard L, Valiquette L, Mills E, Lebel MH, Lavoie G, Carsley J (2001) Severe complications associated with varicella: province of Quebec, April 1994 to March 1996. Can J Infect Dis 12:21–26

    PubMed  CAS  Google Scholar 

  39. Ljungman P, Lönnqvist B, Ringdén O, Skinhöj P, Gahrton G (1989) A randomized trial of oral versus intravenous aciclovir for treatment of herpes zoster in bone marrow transplant recipients. Nordic Bone Marrow Transplant Group. Bone Marrow Transplant 4:613–615

    PubMed  CAS  Google Scholar 

  40. Kashtan CE, Cook M, Chavers BM, Mauer SM, Nevins TE (1997) Outcome of chickenpox in 66 pediatric renal transplant recipients. J Pediatr 131:874–877

    Article  PubMed  CAS  Google Scholar 

  41. Broyer M, Tete MJ, Guest G, Gagnadoux MF, Rouzioux C (1997) Varicella and zoster in children after kidney transplantation: long-term results of vaccination. Pediatrics 99:35–39

    Article  PubMed  CAS  Google Scholar 

  42. Lauzurica R, Bayes B, Frias C, Fontseré N, Hernandez A, Matas L, Jimenez A, Bonet J, Romero R (2003) Disseminated varicella infection in adult renal allograft recipients: Role of mycophenolate mofetil. Transplant Proc 35:1758–1759

    Article  PubMed  CAS  Google Scholar 

  43. Jose MD, Roake JA, Robson RA (2000) The role of mycophenolate mofetil in chickenpox after renal transplantation. Transplantation 70:242–243

    PubMed  CAS  Google Scholar 

  44. Hayes K, Shakuntala V, Pingle A, Dhawan IK, Masri MA (1992) Safe use of aciclovir (Zovirax) in renal-transplant patients on cyclosporine-A therapy – case reports. Transplant Proc 24:1926

    PubMed  CAS  Google Scholar 

  45. Fehr T, Bossart W, Wahl C, Binswanger U (2002) Disseminated varicella infection in adult renal allograft recipients: four cases and a review of the literature. Transplantation 73:608–611

    Article  PubMed  Google Scholar 

  46. Boeckh M, Kim HW, Flowers MED, Meyers JD, Bowden RA (2006) Long-term aciclovir for prevention of varicella zoster virus disease after allogeneic hematopoietic cell transplantation—a randomized double-blind placebo-controlled study. Blood 107:1800–1805

    Article  PubMed  CAS  Google Scholar 

  47. Asano-Mori Y, Kanda Y, Oshima K, Kako S, Shinohara A, Nakasone H, Sato H, Watanabe T, Hosoya N, Izutsu K, Asai T, Hangaishi A, Motokura T, Chiba S, Kurokawa M (2008) Long-term ultra-low-dose aciclovir against varicella-zoster virus reactivation after allogeneic hematopoietic stem cell transplantation. Am J Hematol 83:472–476

    Article  PubMed  CAS  Google Scholar 

  48. Kim DH, Kumar D, Messner HA, Minden M, Gupta V, Kuruvilla J, Chae YS, Sohn SK, Lipton JH (2008) Clinical efficacy of prophylactic strategy of long-term low-dose aciclovir for varicella-zoster virus infection after allogeneic peripheral blood stem cell transplantation. Clin Transplant 22:770–779

    Article  PubMed  Google Scholar 

  49. Aitken C, Hawrami K, Miller C, Muir WB, Yaqoob M, Breuer J (1999) Simultaneous treatment of cytomegalovirus and varicella zoster infections in a renal transplant recipient with ganciclovir: use of viral load to monitor response to treatment. J Med Virol 59:412–414

    Article  PubMed  CAS  Google Scholar 

  50. Steer CB, Szer J, Sasadeusz J, Matthews JP, Beresford JA, Grigg A (2000) Varicella-zoster infection after allogeneic bone marrow transplantation: incidence, risk factors and prevention with low-dose aciclovir and ganciclovir. Bone Marrow Transplant 25:657–664

    Article  PubMed  CAS  Google Scholar 

  51. Dodd DA, Burger J, Edwards KM, Dummer JS (2001) Varicella in a pediatric heart transplant population on nonsteroid maintenance immunosuppression. Pediatrics 108:e80

    Article  PubMed  CAS  Google Scholar 

  52. Goldstein SL, Somers MJG, Lande MB, Brewer ED, Jabs KL (2000) Aciclovir prophylaxis of varicella in children with renal disease receiving steroids. Pediatr Nephrol 14:305–308

    Article  PubMed  CAS  Google Scholar 

  53. Gershon A, Brunell PA, Claps AA, Doyle EF (1972) Steroid-therapy and varicella. J Pediatr 81:1034

    Article  PubMed  CAS  Google Scholar 

  54. Kasper WJ, Howe PM (1990) Fatal varicella after a single course of corticosteroids. Pediatr Infect Dis J 9:729–732

    Article  PubMed  CAS  Google Scholar 

  55. Harmon WE (1991) Opportunistic infections in children following renal-transplantation. Pediatr Nephrol 5:118–125

    Article  PubMed  CAS  Google Scholar 

  56. Melzi ML, Sonzogni A, Comoli P, Stroppa P, Riva S, Altobelli M, Casati A, Torre G, Alberti D, Guizzetti M, Furione M, Spada M, Colledan M, Gridelli B (2006) Specific autologous cytotoxic T lymphocytes for chronic varicella in a liver transplanted child. Pediatr Transplant 10:240–243

    Article  PubMed  Google Scholar 

  57. Gershon AA, LaRussa P, Hardy I, Steinberg S, Silverstein S (1992) Varicella vaccine—the American experience. J Infect Dis 166:S63–S68

    Article  PubMed  Google Scholar 

  58. Krause PR, Klinman DM (1995) Efficacy, immunogenicity, safety, and use of live attenuated chickenpox vaccine. J Pediatr 127:518–525

    Article  PubMed  CAS  Google Scholar 

  59. Rodriguez-Moreno A, Sanchez-Fructuoso AI, Calvo N, Ridao N, Conesa J, Marquez M, Prats D, Barrientos A (2006) Varicella infection in adult renal allograft recipients: experience at one center. Transplant Proc 38:2416–2418

    Article  PubMed  CAS  Google Scholar 

  60. Errasti P, Alvarez ML, Gomez G, Lavilla FJ, Garcia N, Ballester B, García I, Purroy A (1999) Chickenpox in four adult renal transplant recipients. Transplant Proc 31:2341–2342

    Article  PubMed  CAS  Google Scholar 

  61. Shahbazian H, Ehsanpour A (2007) An outbreak of chickenpox in adult renal transplant recipients. Exp Clin Transplant 5:604–606

    PubMed  Google Scholar 

  62. Robertson S, Newbigging K, Carman W, Jones G, Isles C (2006) Fulminating varicella despite prophylactic immune globulin and intravenous aciclovir in a renal transplant recipient: should renal patients be vaccinated against VZV before transplantation? Clin Transplant 20:136–138

    Article  PubMed  Google Scholar 

  63. Ishikawa N, Tanabe K, Shimmura H, Tokumoto T, Toma H (2000) Primary varicella virus in adult renal transplant recipients: case reports. Transplant Proc 32:1952–1953

    Article  PubMed  CAS  Google Scholar 

  64. Levitsky J, Te HS, Faust TW, Cohen SM (2002) Varicella infection following varicella vaccination in a liver transplant recipient. Am J Transplant 2:880–882

    Article  PubMed  Google Scholar 

  65. Pacini-Edelstein SJ, Mehra M, Ament ME, Vargas JH, Martin MG, McDiarmid TV (2003) Varicella in pediatric liver transplant patients: a retrospective analysis of treatment and outcome. J Pediatr Gastroenterol Nutr 37:183–186

    Article  PubMed  Google Scholar 

  66. Levitsky J, Kalil AC, Meza JL, Hurst GE, Freifeld A (2005) Chicken pox after pediatric liver transplantation. Liver Transplant 11:1563–1566

    Article  Google Scholar 

  67. Donati M, Zuckerman M, Dhawan A, Hadzic N, Heaton N, North-Lewis P, Mieli-Vergani G (2000) Response to varicella immunization in pediatric liver transplant recipients. Transplantation 70:1401–1404

    Article  PubMed  CAS  Google Scholar 

  68. Carby M, Jones A, Burke M, Hall A, Banner N (2007) Varicella infection after heart and lung transplantation: a single-center experience. J Heart Lung Transplant 26:399–402

    Article  PubMed  Google Scholar 

  69. Cabezón Ruiz SC, Cisneros JM, Lage Galle EL, Ordónez A, Hinojosa RF, Moràn Risco JE, Hernández A (2003) Characteristics and repercussion of varicella-zoster virus infection in cardiac transplant. Transplant Proc 35:2004–2005

    Article  PubMed  Google Scholar 

  70. Vossen MTM, Gent MR, Weel JFL, de Jong MD, van Lier RAW, Kuijpers TW (2004) Development of virus-specific CD4+ T cells on reexposure to varicella-zoster virus. J Infect Dis 190:72–82

    Article  PubMed  Google Scholar 

  71. Watson B, Rothstein E, Bernstein H, Arbeter A, Arvin A, Chartrand S, Clements D, Kumar ML, Reisinger K, Blatter M, Starr SE, Staehle B, Ngai A, White CJ (1995) Safety and cellular and humoral immune responses of a booster dose of varicella vaccine 6 years after primary immunization. J Infect Dis 172:217–219

    Article  PubMed  CAS  Google Scholar 

  72. Zerboni L, Nader S, Aoki K, Arvin AM (1998) Analysis of the persistence of humoral and cellular immunity in children and adults immunized with varicella vaccine. J Infect Dis 177:1701–1704

    Article  PubMed  CAS  Google Scholar 

  73. Watson B (2008) Humoral and cell-mediated immune responses in children and adults after 1 and 2 doses of varicella. J Infect Dis 197:S143–S146

    Article  PubMed  Google Scholar 

  74. Weinberg A, Levin MJ (2010) VZV T cell-mediated immunity. Curr Top Microbiol Immunol 342:341–357

    Google Scholar 

  75. Prelog M, Zimmerhackl LB (2010) Varicella vaccination in pediatric kidney and liver transplantation. Pediatr Transplant 14:41–47

    Article  PubMed  Google Scholar 

  76. Zamora I, Simon JM, Da Silva ME, Piqueras AI (1994) Attenuated varicella virus vaccine in children with renal transplants. Pediatr Nephrol 8:190–192

    Article  PubMed  CAS  Google Scholar 

  77. Weinberg A, Horslen SP, Kaufman SS, Jesser R, Devoll-Zabrocki A, Fleckten BL, Kochanowicz S, Seipel KR, Levin MJ (2006) Safety and immunogenicity of varicella-zoster virus vaccine in pediatric liver and intestine transplant recipients. Am J Transplant 6:565–568

    Article  PubMed  CAS  Google Scholar 

  78. Kano H, Mizuta K, Sakakihara Y, Kato H, Miki Y, Shibuya N, Saito M, Norita M, Kawarasaki H, Igarashi T, Hashizume K, Iwata T (2002) Efficacy and safety of immunization for pre- and post-liver transplant children. Transplantation 74:543–550

    Article  PubMed  CAS  Google Scholar 

  79. Olson AD, Shope TC, Flynn JT (2001) Pretransplant varicella vaccination is cost-effective in pediatric renal transplantation. Pediatr Transplant 5:44–50

    Article  PubMed  CAS  Google Scholar 

  80. Fadrowski JJ, Furth SL (2004) Varicella zoster virus: vaccination and implications in children with renal failure. Expert Rev Vaccines 3:291–298

    Article  PubMed  CAS  Google Scholar 

  81. Kitai IC, King S, Gafni A (1993) An economic-evaluation of varicella vaccine for pediatric liver and kidney-transplant recipients. Clin Infect Dis 17:441–447

    Article  PubMed  CAS  Google Scholar 

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  1. Department of Pediatrics, Pediatrics I, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria

    Martina Prelog, Jörn Schönlaub & Lothar Bernd Zimmerhackl

  2. University Children’s Hospital, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany

    Martina Prelog

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Lothar Bernd Zimmerhackl is deceased.

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Prelog, M., Schönlaub, J. & Zimmerhackl, L.B. Aciclovir and Varicella-zoster-immunoglobulin in solid-organ transplant recipients. Pediatr Nephrol 26, 663–673 (2011). https://doi.org/10.1007/s00467-010-1666-z

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