Low complication rate in immunocompromised children with varicella-zoster virus infections in a single centre

Acta Paediatr. 2020 Jul;109(7):1409-1416. doi: 10.1111/apa.15118. Epub 2019 Dec 15.

Abstract

Aim: Recent studies focusing on morbidity and mortality rates of immunocompromised children with varicella-zoster virus (VZV) infections are scarce. We aimed to summarise our experience.

Methods: The study was a retrospective analysis of the medical records of children, who were admitted to Hadassah-Hebrew University Medical Centre, Jerusalem, Israel, during the period of 2008-2016. Data regarding baseline characteristics, treatment and outcome were extracted from patient's medical files.

Results: We enrolled 74 patients (43% males) with a mean age of 8 (1-19) years. Most patients (72%) had no reported complications. Clinical outcome was favourable with 73 (99%) patients who had completely recovered and none died. Multivariable analysis identified the presence of fever (P = .005 and 0.02; hazard ratio (HR) 7.72 and 17.61, for total and herpes zoster groups, respectively) and prolonged interval period from clinical presentation to treatment onset (P = .021 and 0.025; HR 1.68 and 2.26, respectively), as associated with higher rates of complications.

Conclusion: Our results found low complication rate of VZV-associated infections in immunocompromised children admitted to a single centre. This should encourage conducting further large multicentre studies evaluating management of low-risk patients with oral acyclovir treatment.

Keywords: chickenpox; herpes zoster; immunocompromised; outcome; varicella-zoster virus.

MeSH terms

  • Acyclovir
  • Adolescent
  • Adult
  • Chickenpox* / drug therapy
  • Chickenpox* / epidemiology
  • Child
  • Female
  • Herpes Zoster* / drug therapy
  • Herpes Zoster* / epidemiology
  • Herpesvirus 3, Human
  • Humans
  • Immunocompromised Host
  • Israel / epidemiology
  • Male
  • Retrospective Studies
  • Young Adult

Substances

  • Acyclovir