Low‐dose acyclovir prophylaxis for the prevention of herpes simplex virus disease after allogeneic hematopoietic stem cell transplantation

Kawamura, Koji; Wada, Hiroo; Yamasaki, Ryo; Ishihara, Yuko; Sakamoto, Kana; Ashizawa, Masahiro; Sato, Miki; Machishima, Tomohito; Terasako, Kiriko; Kimura, Shun‐ichi; Kikuchi, Misato; Nakasone, Hideki; Yamazaki, Rie; Kanda, Junya; Kako, Shinichi; Tanihara, Aki; Nishida, Junji

doi:10.1111/tid.12118

Cited by 35 publications

(36 citation statements)

References 24 publications

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“…In previous studies, HSV disease after auto-and allo-HCT occurs in approximately 70-80 % of seropositive recipients without prophylaxis [1]. Low-dose acyclovir (200 mg/day) appeared to be effective for preventing HSV disease and was comparable to the Japanese standard dose (1000 mg/day) in the early phase after auto-HCT.…”

Section: Discussionmentioning

confidence: 85%

“…We previously reported that a low dose of acyclovir (200 mg/day) could reduce HSV and VZV disease in allogeneic recipients [1,10,11]. Therefore, in the present study, we retrospectively evaluated low-dose acyclovir prophylaxis for the prevention of HSV and VZV disease in auto-HCT patients.…”

Section: Introductionmentioning

confidence: 98%

“…The cumulative incidence of HSV disease is approximately 70-80 % in seropositive patients without prophylaxis [1]. HSV disease sometimes causes severe oral or genital ulceration, esophagitis, and disseminated diseases, although rarely life threatening.…”

Section: Introductionmentioning

confidence: 99%

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Low-dose acyclovir prophylaxis for the prevention of herpes simplex virus and varicella zoster virus diseases after autologous hematopoietic stem cell transplantation

et al. 2015

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Limited data are available on prophylaxis for herpes simplex virus (HSV) and varicella zoster virus (VZV) disease following autologous hematopoietic stem cell transplantation (auto-HCT). We retrospectively reviewed the clinical charts of 105 consecutive patients who underwent their first auto-HCT at our institution between September 2007 and June 2014. Before August 2009, 30 patients received oral acyclovir at 1000 mg/day until engraftment, whereas after September 2009, 69 patients received oral acyclovir at 200 mg/day. After engraftment, acyclovir was continued at 200 mg/day at the discretion of the attending physicians in both groups. The cumulative incidence of HSV disease at 1 year after auto-HCT was 7.7 and 4.5 % in patients who received oral acyclovir at 1000 and 200 mg/day, respectively (P = 0.75). Patients were next divided into three groups according to the timing at which acyclovir prophylaxis was stopped after auto-HCT; at engraftment, between engraftment and 1 year after auto-HCT, and later than 1 year. The cumulative incidence of VZV disease was 25.8, 7.7, and 0.0 % at 1 year, respectively. This study suggests that low-dose acyclovir prophylaxis may be effective for preventing HSV and VZV disease after auto-HCT. Our findings support the recommendation of acyclovir prophylaxis within the first year after auto-HCT.

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Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 98%

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Low-dose acyclovir prophylaxis for the prevention of herpes simplex virus and varicella zoster virus diseases after autologous hematopoietic stem cell transplantation

et al. 2015

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“…As prophylaxis against HSV infection and varicella zoster infection, acyclovir was given from days − 7 to 35, followed by long-term low-dose (200 mg/day) administration. 17,18 CMV antigenemia assay using C10/C11 antibody was performed at least once a week after engraftment and preemptive therapy with ganciclovir was started for high-risk patients. 19 Acute GVHD was graded as previously described.…”

Section: Other Transplantation Proceduresmentioning

confidence: 99%

A randomized controlled trial of cyclosporine and tacrolimus with strict control of blood concentrations after unrelated bone marrow transplantation

Kanda

Kobayashi

Mori

et al. 2015

Bone Marrow Transplant

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Previous studies have suggested that tacrolimus (TAC) is more potent than cyclosporine (CSA) for prophylaxis against acute GVHD after allogeneic hematopoietic stem cell transplantation (HSCT). However, the target blood concentrations of these drugs in these studies were not consistent with the current recommendations. Therefore, we performed a randomized controlled trial to compare CSA and TAC with target blood concentrations of 500 and 15 ng/ml, respectively, to prevent acute GVHD after unrelated HSCT. A total of 107 patients were randomized into a CSA group (n = 53) or a TAC group (n = 54). During the first 4 weeks after HSCT, more than 90% of the patients achieved a mean blood concentration of between 80 and 120% of the target concentration. The incidences of grade II-IV and grade III-IV acute GVHD were 39.6 and 7.5% for the CSA group and 33.3 and 9.4% for the TAC group, respectively (P = 0.41 and P = 0.76). Other clinical outcomes, including overall survival, disease-free survival and the incidences of relapse, non-relapse mortality, and organ toxicities, were also equivalent. We concluded that the combinations of CSA and TAC with strict dose adjustment showed similar efficacies and toxicities as prophylaxis against acute GVHD after unrelated HSCT.

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“…Although such treatments may control the disease to some extent, they are still far away from satisfactory in curing the disease and controlling the spread of viruses [2]. In addition, long-term drug administration may result in side effects as well as drug tolerance [3,4,5,6,7]. Many investigators consider that the generation of specific active immune responses against viruses may be the most effective approach to control viral infections, therefore efforts are made in designing vaccines which can induce strong specific active antiviral immune responses [8,9,10].…”

Section: Introductionmentioning

confidence: 99%

Topical Administration Is a Promising Inoculating Route versus Intramuscular Inoculation for the Nanoparticle-Carried DNA Vaccine to Prevent Corneal Infections

Malla²,

Zhai³

et al. 2015

Ophthalmic Res

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Purpose: To evaluate the comparative effect of topical versus intramuscular administration of nanoparticle-carried DNA vaccine in preventing corneal herpes simplex virus type 1 (HSV-1) infection. Methods: Nanoparticle [polyethylenimine (PEI)-Fe₃O₄]-carried DNA vaccine (PEI-Fe₃O₄-pRSC-gD-IL-21) or DNA vaccine (pRSC-gD-IL-21) alone were topically versus intramuscularly inoculated into one eye each of mice on days 0, 14 and 28. Three weeks after the final immunization, the specific immune responses and clinical degrees of primary herpes simplex keratitis were evaluated. Results: Topical inoculation of nanoparticle-carried DNA vaccine induced mice to generate similar levels of specific HSV-1-neutralizing antibody, IFN-γ and IL-4 in serum and specific killing (cytotoxicity) and proliferative activities of the splenic lymphocytes, but a significantly higher level of secretory IgA in tears compared to those of intramuscular inoculation. More importantly, the mice inoculated topically showed a significantly decreased herpes simplex keratitis severity than the mice inoculated intramuscularly after HSV-1 challenge on the corneas of the mice. Conclusions: Topical inoculation of nanoparticle-carried DNA vaccine elicits a stronger specific local immune response and more effectively inhibits herpes simplex keratitis as compared to intramuscular inoculation in an HSV-1 ocular challenge mouse model. Thus, topical administration may be a promising inoculating route for the nanoparticle-carried DNA vaccine to prevent corneal infections.

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Low‐dose acyclovir prophylaxis for the prevention of herpes simplex virus disease after allogeneic hematopoietic stem cell transplantation

Abstract: ACV at 200 mg/day appeared to be effective for preventing HSV disease in the early phase after HSCT.

Cited by 35 publications

References 24 publications

Low-dose acyclovir prophylaxis for the prevention of herpes simplex virus and varicella zoster virus diseases after autologous hematopoietic stem cell transplantation

Low-dose acyclovir prophylaxis for the prevention of herpes simplex virus and varicella zoster virus diseases after autologous hematopoietic stem cell transplantation

A randomized controlled trial of cyclosporine and tacrolimus with strict control of blood concentrations after unrelated bone marrow transplantation

Topical Administration Is a Promising Inoculating Route versus Intramuscular Inoculation for the Nanoparticle-Carried DNA Vaccine to Prevent Corneal Infections

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