Disseminated Varicella‐Zoster Virus Infection in Organ Transplant Recipients: A 10‐year Retrospective Study
Bibliographic record
Abstract
BACKGROUND: Data on disseminated herpes zoster (HZ) infections in solid organ transplant (SOT) recipients are limited. We aimed to investigate the clinical characteristics and outcomes of HZ infection in SOT patients presenting with microbiologically confirmed disease. METHODS: All SOT recipients who tested positive for varicella-zoster virus (VZV) from any sample type between January 2013 and December 2022 were included. Disseminated HZ was defined as skin lesions involving > 2 contiguous dermatomes or evidence of end organ disease. An analysis of risk factors associated with disseminated infection was performed. RESULTS: A total of 146 adult SOT patients with confirmed VZV infections were included in the study. Of these, 4 were primary varicella and 142 were HZ. Median time to HZ presentation was 1.8 years (range 0.02-27). Disseminated HZ was diagnosed in 55/142(38.7%). Post-herpetic neuralgia (PHN) occurred in 33(22.6%) patients and vaccine breakthrough in 5(3.5%). Hospitalization was in 101(71.6%) patients, and 5(3.5%) died within 30 days, none attributable to HZ. VZV DNAemia was detected in 12/13 (92.3%) patients with disseminated disease versus 11/29 (37.9%) with localized disease (p = 0.002). Recurrent HZ rate was 10/142 (7.0%) over a median follow-up of 4.1 years with 90% of recurrences occurring in thoracic transplant. On multivariable logistic regression, no clinical factors were associated with disseminated disease. CONCLUSIONS: In a large cohort of SOT patients with VZV, disseminated disease and PHN were frequent. VZV DNAemia was noted in both disseminated and localized infections suggesting that subclinical detection of virus in blood is frequent. The implications of this require further study.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".