Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 187, Issue 5, Pages 801-808Publisher
OXFORD UNIV PRESS INC
DOI: 10.1086/367894
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Funding
- NCI NIH HHS [CA 18029, CA 15704] Funding Source: Medline
- NIAID NIH HHS [K23 AI 01839-01, P01 AI 30731] Funding Source: Medline
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Herpes simplex virus (HSV) commonly reactivates after stem-cell transplantation (SCT), despite acyclovir prophylaxis. Whether HSV-seropositive recipients with HSV-seronegative or type-discordant donors had more frequent and severe HSV infections than those with HSV type-concordant donors was explored. Banked serum samples from HSV-positive SCT recipients and their donors were tested for the presence of HSV antibodies. HSV-1-positive SCT recipients from HSV-1-negative donors had more frequent and longer episodes than HSV-1-positive SCT recipients from HSV-1-positive donors; the proportion of patients receiving antiviral treatment for >10% of follow-up days was 27.4% versus 7.2% (P<.001). Both HSV-1 visceral infection (9.8% vs. 2.2%; P = .001) and acyclovir resistance (5.8% vs. 1.8%; P = .03) were more common in type-discordant than -concordant patients, respectively; these associations were confirmed in multivariable models. Serological testing of donors can identify patients who are at highest risk for HSV-related morbidity, for whom prolonged prophylaxis or donor vaccination (once available) could be considered.
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