valacyclovir and Pneumonia--Viral

The seroprevalence of chickenpox in countries with temperate climate is very high among young people. Only 4% of the infections occur in adults but the clinical course is usually more severe than in children. In adults, The mortality is approximately 40 times higher and the complication rate 25 times higher than in children. Pneumonia is the most frequent complication in adults and may be extremely severe in immunocompromised patients and in pregnant women. Pneumonia must be promptly treated with intravenous aciclovir. Vaccination is indicated in young seronegative patients with supplemental risk factors for severe complications. It is also effective post exposure, preventing or modifying the illness course in up to 90% of exposed people if given within 3 days. Immunoglobulins may be effective as late as 96 hours after exposure. They are frequently used for exposed people at high risk of severe disease, when varicella vaccine is contraindicated.

Topics: Acyclovir; Adult; Antiviral Agents; Chickenpox; Drug Therapy, Combination; Female; Humans; Pneumonia, Viral; Valacyclovir; Valine

Cytomegalovirus infection is a major cause of morbidity and mortality in solid-organ transplant. Low doses of valacyclovir have been administered as cytomegalovirus prophylaxis in our institution for years. To the best of our knowledge, there is no published study of a low-dose regimen for cytomegalovirus prophylaxis in heart transplant patients. Therefore, our aim was to determine the results of low doses of valacyclovir in heart transplant.. Between September 2006 and December 2014, sixty-eight patients underwent orthotopic heart transplants. All of the patients received triple immunosuppressive therapy after surgery. During the next 6 months, sulfamethoxazole/trimethoprim was administered for Pneumocystis jiroveci pneumonia, and toxoplasmosis. Additionally all patients received valacyclovir hydrochloride (1000 mg/d, oral) for cytomegalovirus prophylaxis and nystatin oral rinse for prophylaxis of fungal infections.. There was only 1 cytomegalovirus infection at follow-up. The patient had cytomegalovirus pneumonia at 17-month follow-up. In response to treatment with 1-week intravenous ganciclovir, the patient was discharged with a further 6-month oral valacyclovir therapy (1000 mg/d).. In this study, we hypothesized that daily use of low-dose valacyclovir (1000 mg/d) is not only sufficient for cytomegalovirus prophylaxis but also beneficial in terms of cost.

Topics: Acyclovir; Adolescent; Adult; Antiviral Agents; Cytomegalovirus; Cytomegalovirus Infections; Drug Administration Schedule; Drug Therapy, Combination; Female; Heart Transplantation; Humans; Immunocompromised Host; Immunosuppressive Agents; Male; Middle Aged; Opportunistic Infections; Pneumonia, Viral; Risk Factors; Time Factors; Treatment Outcome; Valacyclovir; Valine; Virus Activation; Young Adult