Herpes Simplex and Varicella-Zoster Virus Infection after Hematopoietic Stem Cell or Solid Organ Transplantation

Abstract

Patients undergoing organ transplantation are at high risk for opportunistic infections caused by human herpesviruses, including herpes simplex virus (HSV) and varicella-zoster virus (VZV). Because infection with these viruses is relatively common in childhood, most diseases occurring in adult transplant patients is caused by reactivation of latent virus. Due to the impaired immunity associated with organ transplantation, HSV and VZV can cause serious and potentially life-threatening diseases, including encephalitis and pneumonitis. The availability of antiviral drugs has allowed effective therapy greatly decreasing morbidity and mortality. Universal antiviral prophylaxis has dramatically reduced the incidence of HSV and VZV disease in the months following transplantation. Vaccination to prevent primary infection and reactivation is becoming an increasingly important management tool for VZV.