Carrier M, Pelletier G B, Cartier R, Leclerc Y, Pelletier L C
Department of Surgery, Montreal Heart Institute, Que.
Can J Surg. 1992 Oct;35(5):513-6.
Infection with herpes simplex virus is common among immunosuppressed patients. In an attempt to prevent such infection, 58 patients (group 1) who underwent cardiac transplantation between 1987 and 1990 were given acyclovir (200 mg orally three times a day) prophylactically throughout their postoperative hospital stay (mean 22 days +/- 1 day). The patients' immunosuppressive protocol included cyclosporine, azathioprine and prednisone. The course of these patients was compared to that of 24 patients (group 2) who underwent cardiac transplantation between 1983 and 1986 but were not given prophylactic antiviral treatment postoperatively. The immunosuppressive protocol in these patients consisted of cyclosporine and prednisone. Herpes infection developed during the 1st year in 5 patients (9%) in group 1 and in 11 patients (46%) in group 2 (p < 0.05). The actuarial rates of freedom from herpes infection at 1, 6 and 12 months after transplantation were 100%, 98% +/- 2% and 95% +/- 3%, respectively, in group 1 and 82% +/- 7%, 58% +/- 11%, 53% +/- 11% in group 2. All viral infections were cutaneous or mucosal, except for one, which developed in a patient with pneumonia. All infections responded well to treatment, although one patient with an infected cornea was left with a permanent visual deficit. The authors conclude that prophylaxis of herpes simplex virus infection with acyclovir administered orally in the early postoperative period is effective in preventing viral infections during the 1st year after cardiac transplantation.
单纯疱疹病毒感染在免疫抑制患者中很常见。为预防此类感染，对1987年至1990年间接受心脏移植的58例患者（第1组）在术后住院期间（平均22天±1天）预防性给予阿昔洛韦（口服200毫克，每日3次）。这些患者的免疫抑制方案包括环孢素、硫唑嘌呤和泼尼松。将这些患者的病程与1983年至1986年间接受心脏移植但术后未接受预防性抗病毒治疗的24例患者（第2组）的病程进行比较。这些患者的免疫抑制方案包括环孢素和泼尼松。第1组5例患者（9%）在第1年内发生疱疹感染，第2组11例患者（46%）发生疱疹感染（p<0.05）。移植后1、6和12个月时，第1组无疱疹感染的精算概率分别为100%、98%±2%和95%±3%，第2组分别为82%±7%、58%±11%、53%±11%。除1例肺炎患者发生的感染外，所有病毒感染均为皮肤或黏膜感染。所有感染对治疗反应良好，尽管1例角膜感染患者留下了永久性视力缺陷。作者得出结论，术后早期口服阿昔洛韦预防单纯疱疹病毒感染对预防心脏移植后第1年的病毒感染有效。
