BACKGROUND: Herpes zoster (HZ) is a common infectious disease after kidney transplantation (KT). The incidence of HZ may increase during cytomegalovirus (CMV) preemptive therapy. We therefore evaluated the incidence, risk factors, and clinical outcomes of HZ after KT, according to the type of CMV prophylaxis used. METHODS: We retrospectively established a cohort of KT recipients who underwent transplantation from June 2008 to May 2010. Patients were categorized into 3 groups according to CMV prophylaxis regimen: Group A (preemptive therapy), Group B (universal prophylaxis <3 months), and Group C (universal prophylaxis >3 months). The incidence rate of HZ was compared in each group, and risk factors for HZ were identified. RESULTS: The incidence rate of HZ was 46.6 (95% confidence interval [CI] 31.4-66.5) per 1000 person-years. The incidence rate was higher in Group A than in Group C (80.0 vs. 13.0 per 1000 person-years; P = 0.001). Median onset time of HZ after KT was shorter in Group A than in Group B (0.9 vs. 9.9 months; P < 0.001) and Group C (0.9 vs. 14.8 months; P = 0.008). Post-herpetic neuralgia occurred in 7 patients (23%). No visceral involvement or death was related to HZ. By multivariate analysis, only female gender (corrected relative risk 1.59; 95% CI 1.09-2.00) was independently associated with HZ development. CONCLUSIONS: In the setting of CMV preemptive therapy, a differentiated varicella zoster virus-specific prophylaxis might be necessary for patients with HZ risk factors.
BACKGROUND: Herpes zoster (HZ) is a common infectious disease after kidney transplantation (KT). The incidence of HZ may increase during cytomegalovirus (CMV) preemptive therapy. We therefore evaluated the incidence, risk factors, and clinical outcomes of HZ after KT, according to the type of CMV prophylaxis used. METHODS: We retrospectively established a cohort of KT recipients who underwent transplantation from June 2008 to May 2010. Patients were categorized into 3 groups according to CMV prophylaxis regimen: Group A (preemptive therapy), Group B (universal prophylaxis <3 months), and Group C (universal prophylaxis >3 months). The incidence rate of HZ was compared in each group, and risk factors for HZ were identified. RESULTS: The incidence rate of HZ was 46.6 (95% confidence interval [CI] 31.4-66.5) per 1000 person-years. The incidence rate was higher in Group A than in Group C (80.0 vs. 13.0 per 1000 person-years; P = 0.001). Median onset time of HZ after KT was shorter in Group A than in Group B (0.9 vs. 9.9 months; P < 0.001) and Group C (0.9 vs. 14.8 months; P = 0.008). Post-herpetic neuralgia occurred in 7 patients (23%). No visceral involvement or death was related to HZ. By multivariate analysis, only female gender (corrected relative risk 1.59; 95% CI 1.09-2.00) was independently associated with HZ development. CONCLUSIONS: In the setting of CMV preemptive therapy, a differentiated varicella zoster virus-specific prophylaxis might be necessary for patients with HZ risk factors.
Authors: Ioanna D Pavlopoulou; Stavroula Poulopoulou; Christina Melexopoulou; Ioanna Papazaharia; George Zavos; Ioannis N Boletis Journal: BMC Infect Dis Date: 2015-07-24 Impact factor: 3.090
Authors: Sun In Hong; Taeeun Kim; Se Yoon Park; Jiwon Jung; Joo Yong Lee; Yong Phil Chong; Heungsup Sung; Sang Oh Lee; Sang Ho Choi; Yang Soo Kim; Jun Hee Woo; Sung Han Kim Journal: Infect Chemother Date: 2016-11-22
Authors: Marcia M L Kho; Stefan Roest; Dominique M Bovée; Herold J Metselaar; Rogier A S Hoek; Annemiek A van der Eijk; Olivier C Manintveld; Joke I Roodnat; Nicole M van Besouw Journal: Front Immunol Date: 2021-03-18 Impact factor: 7.561
Authors: Ricardo M La Hoz; Ashley Wallace; Nicolas Barros; Donglu Xie; Linda S Hynan; Terrence Liu; Christina Yek; Scott Schexnayder; Justin L Grodin; Sonia Garg; Mark H Drazner; Matthias Peltz; Robert W Haley; David E Greenberg Journal: Transpl Infect Dis Date: 2020-12-09