Herpes Zoster Infections in Solid-Organ Transplant Recipients

Area of Science:

• Transplant Surgery
• Infectious Diseases
• Immunology

Background:

• Solid-organ transplant recipients face a heightened risk of complicated and potentially fatal herpes zoster (shingles) infections.
• Understanding the incidence, risk factors, and clinical manifestations of herpes zoster in this vulnerable population is critical for patient management.

Purpose of the Study:

• To investigate the incidence and characteristics of herpes zoster infections in adult solid-organ transplant recipients.
• To identify risk factors and clinical outcomes associated with herpes zoster in kidney, liver, and heart transplant recipients.

Main Methods:

• Retrospective analysis of 1050 adult solid-organ transplant recipients from January 2011 to June 2022.
• Detailed review of 44 patients diagnosed with herpes zoster infections, including transplant type, demographics, clinical presentation, and complications.

Main Results:

• The overall incidence of herpes zoster was 5.2%, with higher rates in heart (9.7%) and kidney (5.1%) transplant recipients.
• Postherpetic neuralgia was more common in patients over 45 years old (P = .006).
• Sacral dermatome involvement was significantly higher in heart transplant recipients (P = .015), and acute neuritis was more frequent in kidney transplant recipients (65.6%).

Conclusions:

• Early and specific treatment, alongside supportive care, is vital for transplant recipients with herpes zoster.
• Implementing antiviral prophylaxis and vaccination strategies for varicella zoster virus (VZV) in transplant candidates is recommended to prevent infections and complications.