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2015 ; 15
(ä): 285
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gab.com Text
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Incidence and risk factors of herpes zoster among adult renal transplant
recipients receiving universal antiviral prophylaxis
#MMPMID26204926
Pavlopoulou ID
; Poulopoulou S
; Melexopoulou C
; Papazaharia I
; Zavos G
; Boletis IN
BMC Infect Dis
2015[Jul]; 15
(ä): 285
PMID26204926
show ga
BACKGROUND: Herpes zoster (HZ) is a significant cause of morbidity and
complications in adult renal transplant recipients. We determined the incidence,
complications and risk factors for the development of HZ after renal
transplantation in a setting using universal antiviral prophylaxis. METHODS: The
medical files of all adult renal transplants, performed between 2004 and 2008,
were retrospectively reviewed to assess the clinical characteristics and risk
factors of HZ. Incident cases of HZ were determined and the probability of
developing post-transplant HZ for all subjects was calculated using the Kaplan
Meier method. A multivariable Cox proportional hazards model was applied to
assess the risk factors associated with the development of HZ. RESULTS: A total
of 450 patients were eligible with a median follow up of 38 months. Twenty nine
subjects (6.4%) developed HZ, the median time to onset was 18 months, only three
of them (10.3%) required hospitalization, and none developed disseminated or
visceral disease and death directly attributed to zoster. However, high rates of
post-herpetic neuralgia (48.7%) were observed. Overall incidence was calculated
at 20.6 cases per 1000 patient-years of follow-up. Following multivariate
analysis, increased age???60 years old, positive pre-transplant history of
varicella related disease and administration of rejection treatment conferred an
increased risk of 4.00-fold (CI: 1.79-8.92), 16.00-fold (CI: 4.62-55.52), and
5.57-fold (CI: 1.56-19.84) respectively, for the development of post-transplant
zoster. CONCLUSIONS: HZ remains a common complication after renal transplantation
in adults under current immunosuppession protocols and universal antiviral
prophylaxis.
|*Chemoprevention/statistics & numerical data
[MESH]
|*Kidney Transplantation/adverse effects/statistics & numerical data
[MESH]
|Adolescent
[MESH]
|Adult
[MESH]
|Aged
[MESH]
|Antiviral Agents/*therapeutic use
[MESH]
|Chickenpox/complications/epidemiology
[MESH]
|Female
[MESH]
|Herpes Zoster/*epidemiology/prevention & control
[MESH]
|Humans
[MESH]
|Incidence
[MESH]
|Male
[MESH]
|Middle Aged
[MESH]
|Neuralgia, Postherpetic/epidemiology
[MESH]
|Retrospective Studies
[MESH]
|Risk Factors
[MESH]
|Transplant Recipients/statistics & numerical data
[MESH]
|Virus Diseases/epidemiology/*prevention & control
[MESH]