A predictive model of herpes zoster after allogeneic hematopoietic stem cell transplantation : VZV reactivation following antiviral prophylaxis discontinuation

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Herpes zoster (HZ) refers to the rash appearing on dermatomes due to varicella zoster virus (VZV) reactivation. The incidence of HZ is significantly higher in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients than in non-HSCT recipients. Although acyclovir prophylaxis is routinely administered to every allo-HSCT recipient for 1 year after transplantation, some individuals eventually develop late-onset HZ after completing prophylaxis. Little information is known about the clinical features of HZ after prophylactic antiviral treatment discontinuation, and an effective predictive model of late-onset HZ needs to be established. A total of 3366 patients who had received allo-HSCT from 2012 to 2017 were included in our study, among whom 201 developed HZ after 1 year (late-onset HZ). We designed a nested case-control study to identify potential predictors of late-onset HZ. Finally, we established a predictive model using binary logistic regression analysis. Age (p < .001), use of immunosuppressants at +1 year (p < .001), CD4-CD8 ratio at +1 year (p < .001), certain mental disorders (depression, anxiety, insomnia and adjustment disorder) (p < .001), engraftment time of neutrophils (p < .001), and CD8+ cell count at +30 days (p < .001) were independent predictors of late-onset HZ. A risk grading system was established based on regression coefficients. Discrimination and calibration analysis indicated that the model had good performance. We also identified several predictive factors of the incidence of HZ-related complications. This is the first scoring system for predicting the incidence of late-onset HZ after allo-HSCT. This model can be applied to identify individuals at high risk of late-onset HZ in the early period after receiving allo-HSCT.

Errataetall:

RetractionIn: Am J Hematol. 2024 Apr 26;:. - PMID 38665123

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:99

Enthalten in:

American journal of hematology - 99(2024), 4 vom: 04. Apr., Seite 633-641

Sprache:

Englisch

Beteiligte Personen:

Feng, Cheng-Jie [VerfasserIn]
Zhao, Peng [VerfasserIn]
Fu, Hai-Xia [VerfasserIn]
Yan, Chen-Hua [VerfasserIn]
Wang, Chen-Cong [VerfasserIn]
Zhu, Xiao-Lu [VerfasserIn]
He, Yun [VerfasserIn]
Wang, Feng-Rong [VerfasserIn]
Zhang, Yuan-Yuan [VerfasserIn]
Mo, Xiao-Dong [VerfasserIn]
Kong, Yuan [VerfasserIn]
Han, Wei [VerfasserIn]
Wang, Jing-Zhi [VerfasserIn]
Wang, Yu [VerfasserIn]
Chen, Huan [VerfasserIn]
Chen, Yu-Hong [VerfasserIn]
Zhao, Xiang-Yu [VerfasserIn]
Chang, Ying-Jun [VerfasserIn]
Xu, Lan-Ping [VerfasserIn]
Liu, Kai-Yan [VerfasserIn]
Huang, Xiao-Jun [VerfasserIn]
Zhang, Xiao-Hui [VerfasserIn]

Links:

Volltext

Themen:

Antiviral Agents
Journal Article
Retracted Publication

Anmerkungen:

Date Completed 19.03.2024

Date Revised 26.04.2024

published: Print-Electronic

RetractionIn: Am J Hematol. 2024 Apr 26;:. - PMID 38665123

Citation Status MEDLINE

doi:

10.1002/ajh.27090

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM362685622