Rommelaere M, Maréchal C, Yombi J-C, Goffin E, Kanaan N
Division of Nephrology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium.
Transplant Proc. 2012 Nov;44(9):2814-7. doi: 10.1016/j.transproceed.2012.09.090.
Disseminated varicella zoster virus (VZV) infection, whether due to primary infection or reactivation, may be life threatening in renal transplant recipients. The aims of this study were to assess the outcome of disseminated VZV infection in renal transplant recipients and to determine potential risk factors for mortality.
A search of the English literature from 1985 to 2011 using PUBMED was performed. Reports involving renal transplant recipients younger than 16 years of age were excluded.
A total of 56 adult patients presenting with a disseminated cutaneous or visceral VZV infection was included. Seventy percent of cases occurred within 5 years after transplantation, and 89% within 10 years. Visceral complications including disseminated intravascular coagulation occurred in two thirds of patients. Mortality decreased significantly from 47% in the era before 1995 to 17% after 1995 (P = .04). Risk factors for mortality included visceral involvement, use of azathioprine as immunosuppressant, and longer time between transplantation and VZV infection. VZV seropositivity did not influence fatal outcome.
Disseminated VZV infection can be life threatening in renal transplant recipients with a global mortality rate of 30%. This rate seems to have decreased since 1995. Seropositive VZV patients with disseminated infection are not protected from fatal outcome.
播散性水痘带状疱疹病毒（VZV）感染，无论是原发性感染还是再激活感染，在肾移植受者中都可能危及生命。本研究的目的是评估肾移植受者播散性VZV感染的结局，并确定潜在的死亡危险因素。
使用PUBMED对1985年至2011年的英文文献进行检索。排除涉及16岁以下肾移植受者的报告。
共纳入56例出现播散性皮肤或内脏VZV感染的成年患者。70%的病例发生在移植后5年内，89%发生在10年内。三分之二的患者出现包括弥散性血管内凝血在内的内脏并发症。死亡率从1995年前的47%显著降至1995年后的17%（P = 0.04）。死亡的危险因素包括内脏受累、使用硫唑嘌呤作为免疫抑制剂以及移植与VZV感染之间的时间间隔较长。VZV血清阳性并不影响致命结局。
播散性VZV感染在肾移植受者中可能危及生命，总体死亡率为30%。自1995年以来，这一比率似乎有所下降。播散性感染的VZV血清阳性患者并不能免于致命结局。
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