Low complication rate in immunocompromised children with varicella-zoster virus infections in a single centre
Oded Shamriz1, Roni Ben-Ami2, Diana Averbuch3
1Clinical Immunology and Allergy Unit, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel.
Insights
Varicella-zoster virus (VZV) infections in immunocompromised children show low complication rates. Fever and delayed treatment were linked to higher complication risks, suggesting further multicenter studies are warranted.
Area of Science:
- Pediatric Infectious Diseases
- Immunocompromised Hosts
- Virology
Background:
- Limited data exists on morbidity and mortality in immunocompromised children with varicella-zoster virus (VZV) infections.
- This study addresses the scarcity of recent research in this vulnerable pediatric population.
Purpose of the Study:
- To summarize the clinical experience and outcomes of immunocompromised children with VZV infections.
- To identify factors associated with complications in this patient group.
Main Methods:
- Retrospective analysis of medical records from 2008-2016 at a single center.
- Inclusion of 74 immunocompromised children diagnosed with VZV infections.
- Extraction of data on demographics, treatment, and clinical outcomes.
Main Results:
- A low complication rate (28%) was observed among the 74 patients.
- The vast majority (99%) experienced a favorable outcome with complete recovery; no deaths occurred.
- Fever and delayed treatment initiation were significantly associated with increased complication rates (P < .05).
Conclusions:
- VZV infections in immunocompromised children admitted to this center had a low complication rate.
- Further large-scale, multicenter studies are recommended to evaluate management strategies, particularly oral acyclovir for low-risk patients.
Aim:
Recent studies focusing on morbidity and mortality rates of immunocompromised children with varicella-zoster virus (VZV) infections are scarce. We aimed to summarise our experience.
Methods:
The study was a retrospective analysis of the medical records of children, who were admitted to Hadassah-Hebrew University Medical Centre, Jerusalem, Israel, during the period of 2008-2016. Data regarding baseline characteristics, treatment and outcome were extracted from patient's medical files.
Results:
We enrolled 74 patients (43% males) with a mean age of 8 (1-19) years. Most patients (72%) had no reported complications. Clinical outcome was favourable with 73 (99%) patients who had completely recovered and none died. Multivariable analysis identified the presence of fever (P = .005 and 0.02; hazard ratio (HR) 7.72 and 17.61, for total and herpes zoster groups, respectively) and prolonged interval period from clinical presentation to treatment onset (P = .021 and 0.025; HR 1.68 and 2.26, respectively), as associated with higher rates of complications.
Conclusion:
Our results found low complication rate of VZV-associated infections in immunocompromised children admitted to a single centre. This should encourage conducting further large multicentre studies evaluating management of low-risk patients with oral acyclovir treatment.
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