Journal Article

A Predictive Model of Varicella-Zoster Virus Infection after Autologous Peripheral Blood Progenitor Cell Transplantation

Massimo Offidani, Laura Corvatta, Attilio Olivieri, Anna Mele, Marino Brunori, Mauro Montanari, Serena Rupoli, Patrizia Scalari and Pietro Leoni

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 10, pages 1414-1422
Published in print May 2001 | ISSN: 1058-4838
Published online May 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/320157
A Predictive Model of Varicella-Zoster Virus Infection after Autologous Peripheral Blood Progenitor Cell Transplantation

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Varicella-zoster virus (VZV) frequently causes severe infections in patients who have undergone bone marrow transplantation. The frequency of, characteristics of, and risk factors for this infection were studied in 164 patients undergoing autologous peripheral blood progenitor cell transplantation (PBPCT). Twenty-six patients (15.8%) developed VZV infection, and the actuarial risk was 10% at 1 year. No patient had visceral dissemination or died because of VZV, although one-third of the patients developed postherpetic neuralgia. By multivariate analysis, a CD4+ lymphocyte count of <200 cells/µL (P < .0001; odds ratio [OR], 2.0) and a CD8+ lymphocyte count of <800 cells/µL (P = .0073; OR, 2.0) at day 30 after transplantation were factors associated with VZV infection. Patients with both these adverse factors had an actuarial risk of VZV of 48% at 1 year. Patients with deficiency in both CD4+ and CD8+ lymphocytes are at high risk of VZV infection. These patients should be considered as candidates for preventive therapy, but whether for antiviral therapy or vaccination remains to be investigated.

Journal Article.  4742 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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