Prophylactic oral acyclovir after renal transplantation

Area of Science:

• * Immunology
• * Virology
• * Nephrology

Background:

• * Renal transplant recipients are at high risk for herpes virus infections, including herpes simplex virus (HSV) and varicella zoster virus (VZV).
• * Prophylactic antiviral therapy is crucial to prevent significant morbidity and mortality in these immunocompromised patients.

Purpose of the Study:

• * To evaluate the efficacy of oral acyclovir in preventing HSV and VZV infections in renal transplant recipients.
• * To assess the safety and tolerability of acyclovir in this patient population.

Main Methods:

• * A double-blind, placebo-controlled study involving 35 HSV antibody-positive patients post-renal transplantation.
• * Patients received either oral acyclovir (200 mg four times daily) or placebo for 28 days.
• * Weekly monitoring included throat swabs, urine analysis for virus isolation, and serum antibody titers.

Main Results:

• * None of the 18 patients receiving acyclovir developed HSV or VZV infections.
• * In contrast, 9 of 17 placebo recipients experienced HSV infections (P < 0.001), and 2 experienced VZV infections (P < 0.05).
• * Acyclovir treatment led to rapid symptom resolution in five placebo patients who developed severe infections, with no reported drug toxicity.

Conclusions:

• * Oral acyclovir is highly effective in preventing HSV and VZV reactivation in renal transplant patients.
• * Acyclovir is safe and well-tolerated, representing a critical prophylactic agent in this high-risk group.
• * Early intervention with acyclovir can rapidly resolve established viral infections, reducing complications.