Long-Term Oral Acyclovir Usage to Prevent Herpes Zoster Virus Infection After Bone Marrow Transplant

Randomized Trial of Long-Term Oral Acyclovir Usage to Prevent Varicella Zoster Virus Infection After Allogeneic Bone Marrow Transplant

The objective of this study is to prevent reactivation of herpes zoster during the first year after transplant.

Herpes zoster infection occurs in 30% of allogeneic hematopoietic cell transplant (HCT) recipients who had a history of varicella zoster virus (VZV) infection. A safe and effective prevention strategy has not been established.

77 marrow allograft recipients at risk for VZV reactivation were randomized to oral acyclovir 800 mg twice daily or placebo given from day 30 until day 365 and were followed for toxicity and clinical evidence of herpes zoster infection.

Inclusion Criteria:

• 10 years or older
• Both sex (male or female)
• Allogeneic transplant patient for hematologic malignancy or aplastic anemia

Exclusion Criteria:

• Previous intolerance to acyclovir
• Patients who are unavailable for follow-up
• Patients in whom drug compliance may be a problem
• Evidence of active VZV infection
• VZV infection in the initial 1 month after transplant
• Pregnant women, lactating women, or those not using adequate contraception
• Creatinine > 3.0 mg/dl.