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Post-Transplant Events

Clinical relevance of quantitative varicella-zoster virus (VZV) DNA detection in plasma after stem cell transplantation

Bone Marrow Transplantation volume 38, pages 41–46 (2006)Cite this article

Abstract

Detection of Varicella-Zoster virus (VZV) DNA in plasma can facilitate the early recognition of complicated VZV-infection in immunocompromised hosts. The correlation of VZV-DNA in plasma with clinical presentations of VZV-infection and subsequent aciclovir treatment in allogeneic stem cell transplant (allo-SCT) recipients was studied. In 81 consecutive VZV-IgG positive allo-SCT recipients, VZV-DNA was measured at regular time points (1, 2 and 4 months) following allo-SCT and patient records were screened for VZV-related symptoms and aciclovir treatment. Subsequently, possible VZV-cases were studied in detail for the course of VZV-DNA and treatment effects. During the initial screening, VZV-DNA was detectable in seven patients. The survey of VZV-related symptoms revealed five additional possible VZV-cases. In cases where suitable plasma samples were available (10 out of 12), VZV-DNA was present almost simultaneously with the first clinical manifestations. No evidence of a preceding phase detectable by VZV-DNA only could be observed. Treatment with aciclovir was associated with a prompt reduction of VZV-DNA load. Detection of VZV-DNA in plasma in allo-SCT recipients accurately reflected the clinical presentation of VZV-infection and treatment with aciclovir. VZV-DNA detection in plasma of allo-SCT recipients appears clinically relevant as this may support early recognition and therapeutic management of VZV-infections following allo-SCT.

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Acknowledgements

There was no financial support and no conflicts of interest are reported.

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Authors and Affiliations

  1. Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands

    J S Kalpoe, A C M Kroes, S Verkerk, E C J Claas & M F C Beersma

  2. Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands

    R M Y Barge

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  1. J S Kalpoe
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  2. A C M Kroes
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  3. S Verkerk
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  4. E C J Claas
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  5. R M Y Barge
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  6. M F C Beersma
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Correspondence to A C M Kroes.

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Kalpoe, J., Kroes, A., Verkerk, S. et al. Clinical relevance of quantitative varicella-zoster virus (VZV) DNA detection in plasma after stem cell transplantation. Bone Marrow Transplant 38, 41–46 (2006). https://doi.org/10.1038/sj.bmt.1705397

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