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Infections Post Transplant

Valacyclovir prophylaxis for the prevention of Herpes simplex virus reactivation in recipients of progenitor cells transplantation

Bone Marrow Transplantation volume 29, pages 263–267 (2002)Cite this article

Abstract

HSV can cause oral lesions that exacerbate chemotherapy-related mucositis. Intravenous acyclovir is effective in preventing HSV reactivations, but expensive. Valacyclovir has good bioavailability and has not been studied for prophylaxis of HSV among PCT patients. We compared the efficacy and costs of valacyclovir in preventing HSV reactivation among HSV seropositive autologous progenitor cell transplantation (APCT) patients with historical controls in whom intravenous acyclovir or no HSV prophylaxis were used. Valacyclovir group: From October 1997 to April 1999 108 adult patients received valacyclovir 500 mg twice daily from day −3 of APCT until neutropenia recovery or day +30. Valacyclovir was switched to intravenous acyclovir in cases of oral intolerance (17 patients) or suspected HSV reactivation (five patients). Intravenous acyclovir group: From January 1996 to October 1997 43 patients received 5 mg/kg twice-daily intravenous acyclovir from day −3 until recovery from neutropenia. No prophylaxis group: 38 patients from January 1996 to October 1997 did not receive HSV prophylaxis. HSV reactivations were seen in 2.7%, 2% and 45% of patients in the valacyclovir, intravenous acyclovir, and no prophylaxis groups, respectively. Valacyclovir was well tolerated and was the least expensive strategy. Oral valacyclovir was as effective as intravenous acyclovir for the prophylaxis of HSV reactivation in APCT patients.

Bone Marrow Transplantation (2002) 29, 263–267. doi:10.1038/sj.bmt.1703354

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Acknowledgements

We thank GlaxoSmithKline Argentina for the educational grant that helped partially in the financial support of this study.

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Authors and Affiliations

  1. Myeloma and Transplantation Research Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    MC Dignani

  2. FUNDALEU (Foundation for the Fight Against Leukemia), Buenos Aires, Argentina

    A Mykietiuk, M Michelet, D Intile, P Desmery, G Milone & S Pavlovsky

  3. IDEFI (Virology), Buenos Aires, Argentina

    L Mammana

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  1. MC Dignani
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  2. A Mykietiuk
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  8. S Pavlovsky
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Dignani, M., Mykietiuk, A., Michelet, M. et al. Valacyclovir prophylaxis for the prevention of Herpes simplex virus reactivation in recipients of progenitor cells transplantation. Bone Marrow Transplant 29, 263–267 (2002). https://doi.org/10.1038/sj.bmt.1703354

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