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Post-exposure prophylaxis to prevent varicella in immunocompromised children

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,...

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Autores principales: Yamaguchi, Makoto, Tetsuka, Nobuyuki, Okumura, Toshihiko, Haruta, Kazunori, Suzuki, Takako, Torii, Yuka, Kawada, Jun-ichi, Ito, Yoshinori
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9471438/
https://www.ncbi.nlm.nih.gov/pubmed/36120112
http://dx.doi.org/10.1016/j.infpip.2022.100242
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author Yamaguchi, Makoto
Tetsuka, Nobuyuki
Okumura, Toshihiko
Haruta, Kazunori
Suzuki, Takako
Torii, Yuka
Kawada, Jun-ichi
Ito, Yoshinori
author_facet Yamaguchi, Makoto
Tetsuka, Nobuyuki
Okumura, Toshihiko
Haruta, Kazunori
Suzuki, Takako
Torii, Yuka
Kawada, Jun-ichi
Ito, Yoshinori
author_sort Yamaguchi, Makoto
collection PubMed
description 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.
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spelling pubmed-94714382022-09-15 Post-exposure prophylaxis to prevent varicella in immunocompromised children Yamaguchi, Makoto Tetsuka, Nobuyuki Okumura, Toshihiko Haruta, Kazunori Suzuki, Takako Torii, Yuka Kawada, Jun-ichi Ito, Yoshinori Infect Prev Pract Original Research Article 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. Elsevier 2022-08-28 /pmc/articles/PMC9471438/ /pubmed/36120112 http://dx.doi.org/10.1016/j.infpip.2022.100242 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research Article
Yamaguchi, Makoto
Tetsuka, Nobuyuki
Okumura, Toshihiko
Haruta, Kazunori
Suzuki, Takako
Torii, Yuka
Kawada, Jun-ichi
Ito, Yoshinori
Post-exposure prophylaxis to prevent varicella in immunocompromised children
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 Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9471438/
https://www.ncbi.nlm.nih.gov/pubmed/36120112
http://dx.doi.org/10.1016/j.infpip.2022.100242
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