Disseminated vaccine-induced varicella infection in a kidney transplant recipient

Am J Transplant. 2023 Jun 5:S1600-6135(23)00522-1. doi: 10.1016/j.ajt.2023.05.034. Online ahead of print.ABSTRACTA 33-year-old kidney transplant (KT) recipient presented with a disseminated pruritic, painful, vesicular rash and hepatitis three weeks after receiving a varicella vaccine (VAR). A skin lesion biopsy sent to the Centers for Disease Control and Prevention (CDC) for genotyping confirmed vaccine-strain varicella-zoster virus (VZV) (Oka strain; vOka). The patient was successfully treated with intravenous acyclovir during a prolonged hospital stay. This case supports the contraindication of VAR in adult KT recipients and highlights the potential for severe illness when used in this population. Optimally, VZV-seronegative KT candidates should receive VAR before starting immunosuppressive medications. If this opportunity is missed, the recombinant varicella-zoster vaccine (RZV) might be considered following transplantation as it is already recommended to prevent herpes zoster in VZV-seropositive immunocompromised adults. Further study is needed as data are limited on the safety and efficacy of RZV in VZV-seronegative immunocompromised adults for primary varicella prevention.PMID:37286085 | DOI:10.1016/j.ajt.2023.05.034
Source: Herpes - Category: Infectious Diseases Authors: Source Type: research