Incidence and risk factors of herpes zoster among adult renal transplant recipients receiving universal antiviral prophylaxis

BMC Infectious Diseases

Research Article

Stavroula Poulopoulou¹  Ioanna D. Pavlopoulou²  Ioanna Papazaharia³  Ioannis N. Boletis⁴  Christina Melexopoulou⁴  George Zavos⁴ 

[1] Athens University of Economics and Business, Athens, Greece;Paediatric Research Laboratory, National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece;Postgraduate Program, National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece;Renal Transplant Unit, “Laiko” General Hospital, National and Kapodistrian University, Faculty of Medicine, Athens, Greece;

关键词: Herpes zoster;    HZ;    Incidence;    Complications;    Post- herpetic neuralgia;    PHN;    Risk factors;    Renal transplantation;    Adults;   

DOI  :  10.1186/s12879-015-1038-1

 received in 2014-12-26, accepted in 2015-07-16,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundHerpes 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.MethodsThe 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.ResultsA 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.ConclusionsHZ remains a common complication after renal transplantation in adults under current immunosuppession protocols and universal antiviral prophylaxis.

【 授权许可】

CC BY   
© Pavlopoulou et al. 2015