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Acyclovir and renal transplantation.

E Pettersson, B Eklund, K Höckerstedt

    Scandinavian Journal of Infectious Diseases. Supplementum
    |January 1, 1985
    PubMed
    Summary
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    Oral acyclovir effectively prevented herpes simplex virus (HSV) and varicella zoster virus (VZV) reactivation in kidney transplant patients during treatment. However, infections recurred after prophylaxis stopped, indicating a need for ongoing management strategies.

    Area of Science:

    • Nephrology
    • Infectious Diseases
    • Virology

    Background:

    • Renal allograft recipients are susceptible to herpes simplex virus (HSV) and varicella zoster virus (VZV) reactivation.
    • Prophylaxis against viral reactivation is crucial in immunocompromised transplant patients.

    Purpose of the Study:

    • To evaluate the efficacy of oral acyclovir in preventing HSV reactivation in seropositive renal allograft recipients.
    • To assess the impact of acyclovir prophylaxis on HSV and VZV infections post-renal transplantation.

    Main Methods:

    • A double-blind, placebo-controlled study was conducted.
    • 18 patients received oral acyclovir, while 17 received a placebo.
    • Patients were monitored for signs of HSV or VZV infection.

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    Main Results:

    • No patients receiving acyclovir showed signs of HSV infection during prophylaxis.
    • 11 out of 17 placebo recipients developed HSV or VZV infections (p < 0.001).
    • HSV reactivation occurred in 6 patients after acyclovir cessation, and 1 developed shingles.

    Conclusions:

    • Oral acyclovir prophylaxis is effective in preventing HSV and VZV reactivation during treatment in renal allograft recipients.
    • Prophylaxis does not prevent disease recurrence after drug cessation.
    • Early therapeutic intervention or prophylaxis for high-risk patients is recommended.