Incidence, risk factors and outcome of varicella-zoster virus infection inchildren after haematopoietic stem cell transplantation

We report a retrospective analysis of VZV infection after haematopoietic st em cell transplantation (HSCT) in children. Thirty-three (30%) of the total 109 children who were transplanted during a 7 year period developed post-t ransplant VZV infection. Twenty-four of these 33 (73%) children had VZV inf ection within 1 year following HSCT, The cumulative incidences of post-tran splant VZV infection at 1 and 5 years were 26% and 45%, respectively. The p ositive and negative predictive values of pretransplant VZV serology in rec ipients on the development of HZ following HSCT were 39% and 88%, respectiv ely. Pretransplant VZV seropositivity in recipients was the only risk facto r for post-transplant herpes tester (HZ) infection on multivariate analysis , All patients responded to acyclovir, The median duration of VZV infection was 5 days. Three (11%) and one (3%) children with HZ developed visceral d issemination and post-herpetic neuralgia, respectively. No mortality was di rectly attributed to VZV infection. VZV infection remains a major cause of morbidity in children after HSCT, Further studies are warranted to evaluate the potential use of VZV vaccine in these children.