{"id":4025,"date":"2020-04-08T09:54:30","date_gmt":"2020-04-08T09:54:30","guid":{"rendered":"http:\/\/edren.org\/ren\/?page_id=4025"},"modified":"2024-03-20T16:39:08","modified_gmt":"2024-03-20T16:39:08","slug":"vzv","status":"publish","type":"page","link":"https:\/\/edren.org\/ren\/handbook\/transplant-handbook\/infection-prophylaxis-and-treatment\/vzv\/","title":{"rendered":"VZV"},"content":{"rendered":"<p><span style=\"font-family: georgia, palatino, serif;\">Varicella-Zoster Virus (VZV) is a member of the herpesvirus family. It causes chickenpox (varicella) as a primary infection in immunocompetent individuals, and shingles when dormant infections recur in later life.<\/span><\/p>\n<h3><strong><span style=\"color: #993300;\">Varicella<\/span><\/strong><\/h3>\n<p><span style=\"font-family: georgia, palatino, serif;\">Primary infections with VZV can be very serious in immunosuppressed patients. Reactivations of dormant VZV (shingles) are more common and may also be more severe, and may become generalised in highly immunosuppressed patients.<\/span><\/p>\n<p><span style=\"font-family: georgia, palatino, serif;\">Prevention and management have been transformed by immunisation and the availability of effective antiviral agents. VZV immunoglobulin (VZIG, prepared from hyper-immune recovered patients) is no longer first line, except in the first half of pregnancy. Please follow links below to detailed guidance, but general principles are now that:<\/span><\/p>\n<ul style=\"list-style-type: disc;\">\n<li><span style=\"font-family: georgia, palatino, serif;\">Transplant candidates who are seronegative for VZV should be immunised before transplant, as long as live vaccines are safe for them (i.e. not on immunosuppressive therapy). See <a href=\"http:\/\/edren.org\/ren\/handbook\/transplant-handbook\/infection-prophylaxis-and-treatment\/immunisations\/\">Immunisations in transplantation<\/a>.<\/span><\/li>\n<li><span style=\"font-family: georgia, palatino, serif;\">Seronegative transplant patients who come into close contact with someone with active VZV infection should receive prophylaxis with antivirals (aciclovir\/valaciclovir).<\/span><\/li>\n<li><span style=\"font-family: georgia, palatino, serif;\">Prophylactic use of VZIG is now reserved for susceptible women in the first 20 weeks of pregnancy, and for those unable to take aciclovir\/valaciclovir.<\/span><\/li>\n<\/ul>\n<h3><strong><span style=\"color: #993300;\">Shingles (recurrent form of VZV infection)<\/span><\/strong><\/h3>\n<p><span style=\"font-family: georgia, palatino, serif;\">Antivirals are usually indicated early in the course of shingles in immunosuppressed patients.<\/span><\/p>\n<p><span style=\"font-family: georgia, palatino, serif;\">Some transplant patients (generally those aged \u226550 years) will be offered a Shingles vaccine (<em>Shingrix<\/em>; recombinant subunit vaccine i.e. not a live vaccine) to reduce the risk of developing Shingles. Note that there is another Shingles vaccine which is a live attenuated vaccine (<em>Zostavax<\/em>) which immunosuppressed patients should <strong>not<\/strong> receive.<\/span><\/p>\n<h3><span style=\"font-family: georgia, palatino, serif;\"><strong><span style=\"color: #993300;\">Further info<\/span><\/strong><\/span><\/h3>\n<ul style=\"list-style-type: disc;\">\n<li><span style=\"font-family: georgia, palatino, serif;\"><a href=\"https:\/\/www.gov.uk\/government\/publications\/varicella-zoster-immunoglobulin\">Guidance on post-exposure prophylaxis for varicella\/shingles<\/a> (Public Health England)<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Varicella-Zoster Virus (VZV) is a member of the herpesvirus family. It causes chickenpox (varicella) as a primary infection in immunocompetent individuals, and shingles when dormant infections recur in later life. Varicella Primary infections with VZV can be very serious in immunosuppressed patients. Reactivations of dormant VZV (shingles) are more common\u2026<\/p>\n<p> <a class=\"continue-reading-link\" href=\"https:\/\/edren.org\/ren\/handbook\/transplant-handbook\/infection-prophylaxis-and-treatment\/vzv\/\"><span>Continue reading<\/span><i class=\"crycon-right-dir\"><\/i><\/a> <\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1628,"menu_order":43,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"no","_lmt_disable":"","footnotes":""},"class_list":["post-4025","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/4025","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/comments?post=4025"}],"version-history":[{"count":7,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/4025\/revisions"}],"predecessor-version":[{"id":6358,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/4025\/revisions\/6358"}],"up":[{"embeddable":true,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/1628"}],"wp:attachment":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/media?parent=4025"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}