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[Varicella-zoster virus infections in the immunosuppressed child. Treatment with Acyclovir and controls]
Insights
Acyclovir effectively treated varicella and herpes zoster in immunocompromised children, leading to faster recovery and viral clearance. Early treatment showed the most significant benefits, with minimal relapses observed.
Area of Science:
- Virology
- Pediatric Infectious Diseases
- Pharmacology
Context:
- Varicella and herpes zoster infections pose significant risks to immunocompromised children.
- Conventional treatments have varying efficacy and potential side effects.
Purpose:
- To evaluate the efficacy and safety of intravenous Acyclovir in treating varicella and herpes zoster in pediatric patients with immunodeficiency.
- To assess the impact of early Acyclovir administration on clinical outcomes.
Summary:
- Intravenous Acyclovir was administered to 20 immunocompromised children with varicella or herpes zoster over 6 to 11 days.
- Patients receiving Acyclovir within the first 4 days of illness experienced faster cessation of new vesicles and accelerated scarring.
- Viral antigens cleared more rapidly, with virus no longer isolated after day 3 in most cases. Eighteen patients recovered within 6 to 10 days.
Impact:
- Acyclovir demonstrated good tolerability and effectiveness in managing severe varicella-zoster virus infections in immunocompromised children.
- Early intervention with Acyclovir is crucial for optimal outcomes, including rapid symptom resolution and reduced viral shedding.
- Monitoring renal function is recommended during Acyclovir treatment.
Abstract:
Sixty minutes intravenous infusions of Acyclovir were given at 5 to 10 mg/kg 3 times daily for 6 to 11 days in 20 immunodeficient children with varicella (9 cases) and herpes zoster (11 cases) in a controlled open study. Twelve patients had a life-threatening illness. All patients who received therapy before the first 4 days had a more rapid cessation of new vesicles formation and more rapid scarring. Fourteen controlled children had accelerated clearance of viral antigens from vesicles. In 19 cases, virus was no longer isolated after the 3rd day. Eighteen patients recovered within 6 to 10 days. No relapse of varicella zoster virus infections had been observed 1 to 18 months after the end of treatment. Two children with varicellous interstitial pneumonia died 8 and 32 days after the end of treatment. In 3 cases, zoster pains reappeared 8 days after Acyclovir therapy was stopped. The drug was well-tolerated, but control of renal functions is necessary.