Herpes Simplex and Varicella Zoster in Transplant Candidates and Recipients

Living reference work entry


Herpes Simplex Virus (HSV) 1 and 2 and Varicella Zoster Virus (VZV) are ubiquitous alpha-herpes viruses that establish lifelong latency in nerve root ganglia. They are characterized by clinical and subclinical reactivation which can lead to significant morbidity in the transplant population. Primary infection after transplant can also be highly morbid, potentially fatal. Despite significant advances in screening, diagnosis, treatment and prevention, there are further gains to be made in managing these infections in transplant recipients. Thankfully, there are novel modalities on the horizon such that these viral infections could become significantly less morbid in the future.


Herpes Simplex Virus (HSV) Varicella zoster virus (VZV) Herpes Zoster Solid Organ Transplant (SOT) Hematopoietic Stem Cell Transplant (HSCT) Vaccination Reactivation Primary Disease Antiviral Prevention Prophylaxis 


  1. 1.
    Grose C. Pangaea and the out-of-Africa model of varicella-zoster virus evolution and phylogeography. J Virol. 2012;86(18):9558–65.PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    van Delden C, Stampf S, Hirsch HH, Manuel O, Meylan P, Cusini A, et al. Burden and timeline of infectious diseases in the first year after solid organ transplantation in the Swiss Transplant Cohort Study. Clin Infect Dis. 2020.Google Scholar
  3. 3.
    QuickStats: Age-Adjusted Trends in the Prevalence of Herpes Simplex Virus Type 1 (HSV-1) and Herpes Simplex Virus Type 2 (HSV-2) Among Adolescents and Adults Aged 14–49 Years – United States, 1999–2000 Through 2015–2016. MMWR Morb Mortal Wkly Rep [Internet]. 2018;67(6):203. Available from:
  4. 4.
    Globally, an estimated two-thirds of the population under 50 are infected with herpes simplex virus type 1 [Internet]. Available from:
  5. 5.
    Seale L, Jones CJ, Kathpalia S, Jackson GG, Mozes M, Maddux MS, et al. Prevention of herpesvirus infections in renal allograft recipients by low-dose oral acyclovir. JAMA. 1985;254(24):3435–8.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Meyers JD, Flournoy N, Thomas ED. Infection with herpes simplex virus and cell-mediated immunity after marrow transplant. J Infect Dis. 1980;142(3):338–346.PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    Martin-Gandul C, Stampf S, Héquet D, Mueller NJ, Cusini A, van Delden C, et al. Preventive strategies against cytomegalovirus and incidence of α-herpesvirus infections in solid organ transplant recipients: a nationwide cohort study. Am J Transplant [Internet]. 2017;17(7):1813–22. Available from: Scholar
  8. 8.
    Carrega G, Castagnola E, Canessa A, Argenta P, Haupt R, Dini G, et al. Herpes simplex virus and oral mucositis in children with cancer. Support Care Cancer [Internet]. 1994;2(4):266–9. Available from: Scholar
  9. 9.
    Chickenpox | For Healthcare Professionals | Varicella | CDC [Internet]. Available from:
  10. 10.
    Reynolds MA, Kruszon-Moran D, Jumaan A, Schmid DS, McQuillan GM. Varicella seroprevalence in the U.S.: data from the National Health and Nutrition Examination Survey, 1999–2004. Public Health Rep. 2010;125(6):860–9.PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Geel A, Zuidema W, Van Gelder T, Van Doornum G, Weimar W. Successful vaccination against varicella zoster virus prior to kidney transplantation. In: Transplantation Proceedings. Elsevier USA; 2005. p. 952–3.Google Scholar
  12. 12.
    Pergam SA, Forsberg CW, Boeckh MJ, Maynard C, Limaye AP, Wald A, et al. Herpes zoster incidence in a multicenter cohort of solid organ transplant recipients. Transpl Infect Dis [Internet]. 2011;13(1):15–23. Available from: Scholar
  13. 13.
    Sahoo F, Hill JA, Xie H, Leisenring W, Yi J, Goyal S, et al. Herpes zoster in autologous hematopoietic cell Transplant recipients in the era of acyclovir or valacyclovir prophylaxis and novel treatment and maintenance therapies. Biol Blood Marrow Transplant [Internet]. 2017;23:505–11. Scholar
  14. 14.
    Thomson KJ, Hart DP, Banerjee L, Ward KN, Peggs KS, Mackinnon S. The effect of low-dose aciclovir on reactivation of varicella zoster virus after allogeneic haemopoietic stem cell transplantation. Bone Marrow Transplant [Internet]. 2005;35(11):1065–9. Available from: Scholar
  15. 15.
    Weinmann S, Chun C, Schmid DS, Roberts M, Vandermeer M, Riedlinger K, et al. Incidence and clinical characteristics of herpes zoster among children in the varicella vaccine era, 2005–2009. J Infect Dis [Internet]. 2013;208(11):1859–68. Available from: Scholar
  16. 16.
    Surveillance Manual | Varicella | Vaccine Preventable Diseases | CDC [Internet]. Available from:
  17. 17.
    Greenberg MS, Friedman H, Cohen SG, Oh SH, Laster L, Starr S. A comparative study of herpes simplex infections in renal transplant and leukemic patients. J Infect Dis [Internet]. 1987;156. Available from:
  18. 18.
    Wald A, Zeh J, Selke S, Warren T, Ryncarz AJ, Ashley R, et al. Reactivation of genital herpes simplex virus type 2 infection in asymptomatic seropositive persons. N Engl J Med [Internet]. 2000;342(12):844–50. Available from: Scholar
  19. 19.
    Naraqi S, Jackson GG, Jonasson O, Yamashiroya HM. Prospective study of prevalence, incidence, and source of herpesvirus infections in patients with renal allografts. J Infect Dis [Internet]. 1977;136(4):531–40. Available from: Scholar
  20. 20.
    Uhlin M, Stikvoort A, Sundin M, Mattsson J, Remberger M. Risk factors and clinical outcome for herpes simplex virus reactivation in patients after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant [Internet]. 2015;21(2):S170. Available from: Scholar
  21. 21.
    Garib G, Hughey LC, Elmets CA, Cafardi JA, Andea AA. Atypical presentation of exophytic herpes simplex virus type 2 with concurrent cytomegalovirus infection: a significant pitfall in diagnosis. Am J Dermatopathol. 2013;35(3):371–6.PubMedPubMedCentralCrossRefGoogle Scholar
  22. 22.
    Burke EM, Karp DL, Wu TC, Corio RL. Atypical oral presentation of herpes simplex virus infection in a patient after orthotopic liver transplantation. Eur Arch Oto-Rhino-Laryngology. 1994;251(5):301–3.CrossRefGoogle Scholar
  23. 23.
    Redding SW. Role of herpes simplex virus reactivation in chemotherapy-induced oral mucositis. NCI Monogr [Internet]. 1990;(9):103–5. Available from:
  24. 24.
    Danve-Szatanek C, Aymard M, Thouvenot D, Morfin F, Agius G, Bertin I, et al. Surveillance network for herpes simplex virus resistance to antiviral drugs: 3-year follow-up. J Clin Microbiol. 2004;42:242.PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    Cunha BA, Eisenstein LE, Dillard T, Krol V. Herpes simplex virus (HSV) pneumonia in a heart transplant: diagnosis and therapy. Hear Lung J Acute Crit Care. 2007;36(1):72–8.CrossRefGoogle Scholar
  26. 26.
    Smyth RL, Higenbottam TW, Scott JP, Wreghitt TG, Stewart S, Clelland CA, et al. Herpes simplex virus infection in heart-lung transplant recipients. Transplantation. 1990;49(4):735–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Macesic N, Abbott IJ, Kaye M, Druce J, Glanville AR, Gow PJ, et al. Herpes simplex virus-2 transmission following solid organ transplantation: donor-derived infection and transplantation from prior organ recipients. Transpl Infect Dis [Internet]. 2017;19(5):e12739. Available from: Scholar
  28. 28.
    Onozawa M, Hashino S, Haseyama Y, Hirayama Y, Iizuka S, Ishida T, et al. Incidence and risk of postherpetic neuralgia after varicella zoster virus infection in hematopoietic cell transplantation recipients: Hokkaido Hematology Study Group. Biol Blood Marrow Transplant. 2009;15(6):724–9.PubMedCrossRefPubMedCentralGoogle Scholar
  29. 29.
    Yawn BP, Saddier P, Wollan PC, St Sauver JL, Kurland MJ, Sy LS. A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction. Mayo Clin Proc [Internet]. 2007;82. Available from:
  30. 30.
    Fehr T, Bossart W, Wahl C, Binswanger U. Disseminated varicella infection in adult renal allograft recipients: four cases and a review of the literature. Transplantation. 2002;73(4):608–11.PubMedCrossRefPubMedCentralGoogle Scholar
  31. 31.
    American Academy of Pediatrics. Committee on Infectious Diseases, Red Book: Report of the Committee on Infectious Diseases. Kimberlin DW, Brady MT, Jackson MA LS, editor. Committee on Infectious Diseases. 2018.Google Scholar
  32. 32.
    Renoult E, Lanthier S, Rouleau D, Jodoin N, Letourneau-Guillon L, Pâquet M, et al. Varicella zoster virus vasculopathy after kidney transplantation. Transplantation [Internet]. 2016;100(4):e19–20. Available from: Scholar
  33. 33.
    Fall AJ, Aitchison JD, Krause A, Hasan A, Hamilton JR, Gould FK. Donor organ transmission of varicella zoster due to cardiac transplantation. Transplantation [Internet]. 2000;70(1):211–3. Available from: Scholar
  34. 34.
    Gnann JW Jr. Varicella-zoster virus: atypical presentations and unusual complications. J Infect Dis. 2002;186(s1):S91–8.PubMedCrossRefPubMedCentralGoogle Scholar
  35. 35.
    Zuckerman RA, Limaye AP. Varicella zoster virus (VZV) and herpes simplex virus (HSV) in solid organ transplant patients. Am J Transplant [Internet]. 2013;13(Suppl 3):55–66; quiz 66. Available from: Scholar
  36. 36.
    Landry ML. Immunoglobulin M for acute infection: True or false? Clin Vaccine Immunol. 2016;23(7):540–5.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Nichols WG, Boeckh M, Carter RA, Wald A, Corey L. Transferred herpes simplex virus immunity after stem-cell transplantation: clinical implications. J Infect Dis. 2003;187:801.PubMedCrossRefPubMedCentralGoogle Scholar
  38. 38.
    Caviness AC, Oelze LL, Saz UE, Greer JM, Demmler-Harrison GJ. Direct immunofluorescence assay compared to cell culture for the diagnosis of mucocutaneous herpes simplex virus infections in children. J Clin Virol. 2010;49(1):58–60.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Legoff J, Péré H, Bélec L. Diagnosis of genital herpes simplex virus infection in the clinical laboratory. Virol J. 2014;11. BioMed Central Ltd.Google Scholar
  40. 40.
    Lakeman FD, Whitley RJ, Whitley RJ, Alford C, Cobbs CG, Morawetz R, et al. Diagnosis of herpes simplex encephalitis: application of polymerase chain reaction to cerebrospinal fluid from brain-biopsied patients and correlation with disease. J Infect Dis. 1995;171(4):857–63.PubMedCrossRefPubMedCentralGoogle Scholar
  41. 41.
    Weil AA, Glaser CA, Amad Z, Forghani B. Patients with suspected herpes simplex encephalitis: rethinking an initial negative polymerase chain reaction result. Clin Infect Dis [Internet]. 2002;34(8):1154–7. Available from: Scholar
  42. 42.
    Berrington WR, Jerome KR, Cook L, Wald A, Corey L, Casper C. Clinical correlates of herpes simplex virus viremia among hospitalized adults. Clin Infect Dis. 2009;49(9):1295–301.PubMedPubMedCentralCrossRefGoogle Scholar
  43. 43.
    Zuckerman RA. The clinical spectrum of herpes simplex viremia. Clin Infect Dis [Internet]. 2009;49(9):1302–4. Available from: Scholar
  44. 44.
    Morrow R, Friedrich D. Performance of a novel test for IgM and IgG antibodies in subjects with culture-documented genital herpes simplex virus-1 or -2 infection. Clin Microbiol Infect. 2006;12(5):463–9.PubMedCrossRefPubMedCentralGoogle Scholar
  45. 45.
    Leung J, Harpaz R, Baughman AL, Heath K, Loparev V, Vázquez M, et al. Evaluation of laboratory methods for diagnosis of Varicella. Clin Infect Dis. 2010;51(1):23–32.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Nagel MA, Forghani B, Mahalingam R, Wellish MC, Cohrs RJ, Russman AN, et al. The value of detecting anti-VZV IgG antibody in CSF to diagnose VZV vasculopathy. Neurology. 2007;68(13):1069–73.PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Park SY, Kim JY, Kim JA, Kwon JS, Kim SM, Jeon NY, et al. Diagnostic usefulness of varicella-zoster virus real-time polymerase chain reaction analysis of DNA in saliva and plasma specimens from patients with herpes zoster. J Infect Dis. 2018;217(1):51–7.CrossRefGoogle Scholar
  48. 48.
    Wilson DA, Yen-Lieberman B, Schindler S, Asamoto K, Schold JD, Procop GW. Should varicella-zoster virus culture be eliminated? A comparison of direct immunofluorescence antigen detection, culture, and PCR, with a historical review. J Clin Microbiol. 2012;50(12):4120–2.PubMedPubMedCentralCrossRefGoogle Scholar
  49. 49.
    van der Beek MT, Vermont CL, Bredius RGM, Marijt EWA, van der Blij-de Brouwer CS, Kroes ACM, et al. Persistence and antiviral resistance of varicella zoster virus in hematological patients. Clin Infect Dis [Internet]. 2013;56(3):335–43. Available from:
  50. 50.
    Saint-Léger E, Caumes E, Breton G, Douard D, Saiag P, Huraux J, et al. Clinical and virologic characterization of acyclovir-resistant varicella-zoster viruses isolated from 11 patients with acquired immunodeficiency syndrome. Clin Infect Dis [Internet]. 2001;33(12):2061–7. Available from: Scholar
  51. 51.
    Sauerbrei A, Wutzler P. Serological detection of varicella-zoster virus-specific immunoglobulin G by an enzyme-linked immunosorbent assay using glycoprotein antigen. J Clin Microbiol. 2006;44(9):3094–7.PubMedPubMedCentralCrossRefGoogle Scholar
  52. 52.
    McLachlan E, Scholz H, Bolotin S, Crowcroft NS, Hatchette TF, Jackson C, et al. Calibration and evaluation of quantitative antibody titers for varicella-zoster virus by use of the BIOPLEX 2200. J Clin Microbiol. 2019;57(8)Google Scholar
  53. 53.
    Lee DH, Zuckerman RA. Herpes simplex virus infections in solid organ transplantation: guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transpl. 2019;33(9).Google Scholar
  54. 54.
    Setyapranata S, Holt SG, Wiggins KJ, Mulley WR, Kerr PG, Landgren AJ, et al. Renal allograft re-use and herpetic re-infection. Nephrology. 2015;20(1):17–21.PubMedCrossRefPubMedCentralGoogle Scholar
  55. 55.
    Longerich T, Eisenbach C, Penzel R, Kremer T, Flechtenmacher C, Helmke B, et al. Recurrent herpes simplex virus hepatitis after liver retransplantation despite acyclovir therapy. Liver Transplant [Internet]. 2005;11(10):1289–94. Available from: Scholar
  56. 56.
    Wilhelmus KR. The treatment of herpes simplex virus epithelial keratitis. Trans Am Ophthalmol Soc [Internet]. 2000;98:505–32. Available from: Scholar
  57. 57.
    Erard V, Wald A, Corey L, Leisenring WM, Boeckh M. Use of long-term suppressive acyclovir after hematopoietic stem-cell transplantation: impact on herpes simplex virus (HSV) disease and drug-resistant HSV disease. J Infect Dis. 2007;196(2):266–70.PubMedCrossRefPubMedCentralGoogle Scholar
  58. 58.
    Fujii H, Kakiuchi S, Tsuji M, Nishimura H, Yoshikawa T, Yamada S, et al. Application of next-generation sequencing to detect acyclovir-resistant herpes simplex virus type 1 variants at low frequency in thymidine kinase gene of the isolates recovered from patients with hematopoietic stem cell transplantation. J Virol Methods. 2018;251:123–8.PubMedCrossRefPubMedCentralGoogle Scholar
  59. 59.
    Adalsteinsson JA, Pan M, Kaushik S, Ungar J. Foscarnet-induced genital lesions: an overview with a case report. Dermatol Rep. 2018;10(1):12–13.Google Scholar
  60. 60.
    Bacon TH, Levin MJ, Leary JJ, Sarisky RT, Sutton D. Herpes simplex virus resistance to acyclovir and penciclovir after two decades of antiviral therapy. Clin Microbiol Rev [Internet]. 2003;16(1):114–28. Available from: Scholar
  61. 61.
    Prelog M, Schönlaub J, Zimmerhackl LB. Aciclovir and Varicella-zoster-immunoglobulin in solid-organ transplant recipients. Pediatr Nephrol. 2011;26(5):663–73.PubMedCrossRefGoogle Scholar
  62. 62.
    Pergam SA, Limaye AP, AST Infectious Diseases Community of Practice. Varicella zoster virus (VZV) in solid organ transplantation: guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant [Internet]. 2019;4:e13622. Available from: Scholar
  63. 63.
    Nagel MA, Bubak AN. Varicella zoster virus vasculopathy. J Infect Dis [Internet]. 2018;218(suppl_2):S107–12. Available from: Scholar
  64. 64.
    Marin M, Güris D, Chaves SS, Schmid S, Seward JF. Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2007;56(RR-4):1–40.PubMedGoogle Scholar
  65. 65.
    Corey L, Wald A, Patel R, Sacks SL, Tyring SK, Warren T, et al. Once-daily valacyclovir to reduce the risk of transmission of genital herpes. N Engl J Med. 2004;350(1):11–20.PubMedCrossRefGoogle Scholar
  66. 66.
    Hardy I, Gershon AA, Steinberg SP, LaRussa P. The incidence of zoster after immunization with live attenuated varicella vaccine. N Engl J Med [Internet]. 1991;325(22):1545–50. Available from: Scholar
  67. 67.
    Shiraki K, Yamanishi K, Takahashi M. Susceptibility to acyclovir of Oka-strain varicella vaccine and vaccine-derived viruses isolated from immunocompromised patients. J Infect Dis [Internet]. 1984;150(2):306–7. Available from: Scholar
  68. 68.
    Levin MJ, Dahl KM, Weinberg A, Giller R, Patel A, Krause PR. Development of resistance to acyclovir during chronic infection with the Oka vaccine strain of varicella-zoster virus, in an immunosuppressed child. J Infect Dis. 2003;188(7):954–9.PubMedCrossRefGoogle Scholar
  69. 69.
    Sartori AMC. A review of the varicella vaccine in immunocompromised individuals. Int J Infect Dis. 2004;8:259–70. ElsevierPubMedCrossRefGoogle Scholar
  70. 70.
    Marin M, Leung J, Gershon AA. Transmission of vaccine-strain varicella-zoster virus: a systematic review. Pediatrics. 2019;144. American Academy of Pediatrics.Google Scholar
  71. 71.
    Levin MJ. Varicella vaccination of immunocompromised children. J Infect Dis [Internet]. 2008;197(s2):S200–6. Available from: Scholar
  72. 72.
    Harris AE, Styczynski J, Bodge M, Mohty M, Savani BN, Ljungman P. Pretransplant vaccinations in allogeneic stem cell transplantation donors and recipients: an often-missed opportunity for immunoprotection? Bone Marrow Transplant. 2015;50(7):899–903.PubMedCrossRefPubMedCentralGoogle Scholar
  73. 73.
    Tomblyn M, Chiller T, Einsele H, Gress R, Sepkowitz K, Storek J, et al. Guidelines for preventing infectious complications among hematopoietic cell transplantation recipients: a global perspective. Biol Blood Marrow Transplant. 2009;15(10):1143–1238.PubMedPubMedCentralCrossRefGoogle Scholar
  74. 74.
    Updated recommendations for use of VariZIG-United States, 2013. Am J Transplant [Internet]. 2013;13(10):2765–7. Available from:
  75. 75.
    Ishida Y, Tauchi H, Higaki A, Yokota-Outou Y, Kida K. Postexposure prophylaxis of varicella in children with leukemia by oral acyclovir. Pediatrics. 1996;97(1):150–151.Google Scholar
  76. 76.
    Asano Y, Yoshikawa T, Suga S, Kobayashi I, Nakashima T, Yazaki T, et al. Postexposure prophylaxis of varicella in family contact by oral acyclovir. Pediatrics [Internet]. 1993;92(2):219–22. Available from: Scholar
  77. 77.
    Weinstock DM, Boeckh M, Boulad F, Eagan JA, Fraser VJ, Henderson DK, et al. Postexposure prophylaxis against varicella-zoster virus infection among recipients of hematopoietic stem cell transplant: unresolved issues. Infect Control Hosp Epidemiol. 2004;25(7):603–8.PubMedCrossRefPubMedCentralGoogle Scholar
  78. 78.
    Lee YJ, Neofytos D, Kim SJ, Cheteyan L, Huang Y-T, Papadopoulos EB, et al. Efficacy of brincidofovir as prophylaxis against HSV and VZV in hematopoietic cell transplant recipients. Transpl Infect Dis [Internet]. 2018;20(6):e12977. Available from: Scholar
  79. 79.
    Dvorak CC, Cowan MJ, Horn B, Weintrub PS. Development of herpes simplex virus stomatitis during receipt of cidofovir therapy. Clin Infect Dis [Internet]. 2009;49(8):e92–5. Available from: Scholar
  80. 80.
    Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD, et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med. 2005;352(22):2271–2284.Google Scholar
  81. 81.
    Lal H, Cunningham AL, Godeaux O, Chlibek R, Diez-Domingo J, Hwang S-J, et al. Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. N Engl J Med [Internet]. 2015;372(22):2087–96. Available from: Scholar
  82. 82.
    Bastidas A, De La Serna J, El Idrissi M, Oostvogels L, Quittet P, López-Jiménez J, et al. Effect of recombinant zoster vaccine on incidence of herpes zoster after autologous stem cell transplantation: a randomized clinical trial. JAMA. 2019;322(2):123–33.PubMedPubMedCentralCrossRefGoogle Scholar
  83. 83.
    Vink P, Ramon Torrell JM, Sanchez Fructuoso A, Kim S-J, Kim S, Zaltzman J, et al. Immunogenicity and safety of the adjuvanted recombinant zoster vaccine in chronically immunosuppressed adults following renal transplant: a phase III, randomized clinical trial. Clin Infect Dis. 2019;70(2):181–190.Google Scholar
  84. 84.
    Distler E, Schnürer E, Wagner E, von Auer C, Plachter B, Wehler D, et al. Recovery of varicella-zoster virus-specific T cell immunity after T cell-depleted allogeneic transplantation requires symptomatic virus reactivation. Biol Blood Marrow Transplant. 2008;14(12):1417–24.PubMedCrossRefPubMedCentralGoogle Scholar
  85. 85.
    Meyers JD, Flournoy N, Thomas ED. Cell-mediated immunity to varicella-zoster virus after allogeneic marrow transplant. J Infect Dis [Internet]. 1980;141(4):479–87. Available from: Scholar
  86. 86.
    Winston DJ, Mullane KM, Cornely OA, Boeckh MJ, Brown JW, Pergam SA, et al. Inactivated varicella zoster vaccine in autologous haemopoietic stem-cell transplant recipients: an international, multicentre, randomised, double-blind, placebo-controlled trial. Lancet. 2018;391(10135):2116–27.PubMedCrossRefPubMedCentralGoogle Scholar
  87. 87.
    Locke FL, Menges M, Nishihori T, Nwoga C, Alsina M, Anasetti C. Boosting humoral and cellular immunity to pneumococcus by vaccination before and just after autologous transplant for myeloma. Bone Marrow Transpl. 2016;51:291–4. Nature Publishing GroupCrossRefGoogle Scholar
  88. 88.
    Ljungman P, Engelhard D, de la Cámara R, Einsele H, Locasciulli A, Martino R, et al. Vaccination of stem cell transplant recipients: recommendations of the Infectious diseases Working Party of the EBMT. Bone Marrow Transplant. 2005;35(8):737–46.PubMedCrossRefPubMedCentralGoogle Scholar
  89. 89.
    Curran D, Matthews S, Rowley SD, Young J-AH, Bastidas A, Anagnostopoulos A, et al. Infectious disease recombinant zoster vaccine significantly reduces the impact on quality of life caused by herpes zoster in adult autologous hematopoietic stem cell transplant recipients: a randomized placebo-controlled trial (ZOE-HSCT) biology of blood. Biol Blood Marrow Transpl [Internet]. 2019;25:2474–81. Available from: Scholar
  90. 90.
    Macartney K, Heywood A, Mcintyre P. Vaccines for post-exposure prophylaxis against varicella (chickenpox) in children and adults. Cochrane Database Syst Rev. 2014; 2014. John Wiley and Sons Ltd.Google Scholar
  91. 91.
    Genital HSV Infections – 2015 STD Treatment Guidelines [Internet]. Available from:
  92. 92.
    American College of Obstetricians and Gynecologists. Cytomegalovirus, parvovirus B19, varicella zoster, and toxoplasmosis in pregnancy. Practice Bulletin No. 151. American College of Obstetricians and Gynecologists. Obstet Gynecol [Internet]. 2015;125(6):1510–25. Available from:
  93. 93.
    Chen YC, Sheng J, Trang P, Liu F. Potential application of the CRISPR/CAS9 system against herpesvirus infections. Viruses. 2018;10. MDPI AG.Google Scholar
  94. 94.
    Ciceri F, Bonini C, Labopin M, Oliveira G, Nagler A, Yannaki E, et al. Safety and efficacy of donor T cells engineered with herpes simplex virus thymidine-kinase suicide gene (TK cells) given after T-cell depleted (TCD) haploidentical hematopoietic transplantation (Haplo-HSCT): results of a 14-year follow-up in 45 patients. Biol Blood Marrow Transpl [Internet]. 2017;23(3):S54–5. Available from: Scholar

Authors and Affiliations

  1. 1.Infectious Disease and International HealthDartmouth-Hitchcock Medical CenterLebanonUSA

Section editors and affiliations

  • Camille Nelson Kotton
    • 1
  1. 1.Infectious Diseases DivisionHarvard University Medical SchoolBostonUSA

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