{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T20:56:05Z","timestamp":1787950565405,"version":"build-2784847793"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Varicella\u2010zoster virus (VZV) reactivation is the most common infectious complication in the late posthematopoietic stem cell transplantation (HSCT) period and is reported as 16%\u201341%. Acyclovir prophylaxis is recommended for at least 1\u2009year after HSCT to prevent VZV infections. However, studies on the most appropriate prophylaxis are ongoing in pediatric patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent allogeneic HSCT between January 1, 1996 and January 1, 2020 were retrospectively analyzed to outline the characteristics of VZV reactivation after allogeneic HSCT in pediatric patients using 6\u2009months acyclovir prophylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 260 patients and 273 HSCTs. Median age was 10.43 (0.47\u201318.38), and 56% was male. Median follow\u2010up was 2325\u2009days (18\u20137579\u2009days). VZV reactivation occurred in 21.2% (<jats:italic>n<\/jats:italic>\u2009=\u200958) at a median of 354 (55\u20133433) days post\u2010HSCT. The peak incidence was 6\u201312\u2009months post\u2010HSCT (43.1%). Older age at HSCT, female gender, history of varicella infection, lack of varicella vaccination, low lymphocyte, CD4 count, and CD4\/CD8 ratio at 9 and 12\u2009months post\u2010HSCT was found as a significant risk for herpes zoster (HZ) in univariate analysis, whereas history of varicella infection and low CD4\/CD8 ratio at 12\u2009months post\u2010HSCT was an independent risk factor in multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Tailoring acyclovir prophylaxis according to pre\u2010HCT varicella history, posttransplant CD4 T lymphocyte counts and functions, and ongoing immunosuppression may help to reduce HZ\u2010related morbidity and mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14819","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T12:50:57Z","timestamp":1719406257000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Varicella\u2010Zoster Virus Reactivation After Pediatric Allogeneic Hematopoietic Stem Cell Transplantation, Single\u2010Center Experience of Acyclovir Prophylaxis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7241-8957","authenticated-orcid":false,"given":"Galip","family":"Ar\u0131c\u0131","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology Etlik City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6846-6048","authenticated-orcid":false,"given":"Elif","family":"Ince","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology Ankara University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5491-7947","authenticated-orcid":false,"given":"Erdal","family":"Ince","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Memorial Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0244-353X","authenticated-orcid":false,"given":"Talia","family":"Ileri","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology Ankara University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4955-160X","authenticated-orcid":false,"given":"Ergin","family":"Ciftci","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infection Ankara University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7869-4941","authenticated-orcid":false,"given":"Figen","family":"Dogu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology Ankara University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7318-1688","authenticated-orcid":false,"given":"Halil","family":"Ozdemir","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infection Ankara University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0152-1564","authenticated-orcid":false,"given":"Hasan\u00a0Fatih","family":"Cakmakli","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology Ankara University Faculty of Medicine  Ankara 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