Prevention of herpesvirus infections in renal allograft recipients by low-dose oral acyclovir
L. Seale, C. J. Jones, S. Kathpalia, G. G. Jackson, M. Mozes, M. S. Maddux and D. Packham
Forty patients with serum antibody against herpes simplex virus (HSV) were
enrolled in a randomized, placebo-controlled, double-blind investigation of
acyclovir given orally in a low dosage as prophylaxis against recurrent HSV
infection after renal transplantation. During 30 postoperative days of
medication, 14 of 21 placebo-treated and one of 19 acyclovir-treated
patient(s) developed reactivation of HSV infection. Eleven of the former,
but not the latter, had herpetic lesions. The protection against active
infection with HSV during the period of prophylaxis with acyclovir is
statistically highly significant. From 30 to 90 days after transplantation
when no antiviral medicine was given, 60% (3/5) of the remaining placebo
recipients and 44% (7/16) of the acyclovir patients developed active HSV
infections. Herpetic lesions occurred in two of three and two of seven of
infected people in the respective groups. No adverse effects of the drug
were observed. The results show that HSV infections in immunosuppressed
renal allograft recipients can be safely prevented, deferred, and
ameliorated by an initial period of prophylaxis with a low dose of oral
acyclovir.
