What are the IASP recommendations for the treatment of herpes zoster (shingles) in immunocompromised patients?

Updated: Jan 25, 2019
  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

IASP recommendations for immunocompromised patients are as follows [1] :

  • Intravenous acyclovir is the therapy of choice for allogeneic hematopoietic stem cell transplant recipients within 4 months of transplantation, hematopoietic stem cell transplant recipients with moderate-to-severe acute or chronic graft versus host disease, or any transplant recipient receiving aggressive antirejection therapy.

  • For less severely immunosuppressed patients, oral therapy with acyclovir, valacyclovir, or famciclovir, coupled with close clinical observation, is a reasonable option.

  • Brivudin is not recommended for patients undergoing chemotherapy with 5-fluoropyrimidines.

  • For highly immunocompromised patients who present with herpes zoster ophthalmicus, intravenous acyclovir and evaluation by an ophthalmologist is recommended.


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