TY - JOUR
T1 - Prevention of Infections in Patients with T Cell Defects
AU - Hughes, Walter T.
N1 - Funding Information:
Financial support: This work was supported in part by grants from the National Institutes of Health (R01 AI 20673-10, ACTG 175501, Cancer Center [CORE] P30 CA 21765) and by the American Lebanese Syrian Associated Charities.
PY - 1993/11
Y1 - 1993/11
N2 - Although no specific infection is limited entirely to hosts with T-lymphocyte defects, certain microbial organisms have an affinity for such individuals. Effective, safe, and feasible methods are available for the prevention of two of the major life-threatening infections in patients with T-lymphocyte defects, although none of these methods is ideal. Trimethoprim-sulfamethoxazole administered orally daily or thrice weekly is highly effective for the prevention of Pneumocystis carinii pneumonia. For patients who cannot tolerate this drug combination, monthly inhalation of aerosolized pentamidine is an alternative prophylactic approach. Additional drugs in clinical or preclinical trials offer promise for use in preventing this pneumonitis. Varicella is one of the most frequent serious viral infections in patients with cancer, especially children. Varicella-zoster immune globulin (VZIG) has proven effective in reducing the frequency of infection in exposed susceptible individuals; however, breakthrough infections are not uncommon. Of 358 children with acute lymphoblastic leukemia, 62 received VZIG following exposure to varicella, and 16 (26%) of these had breakthrough varicella. A live attenuated varicella-zoster virus vaccine offers promise, especially for the universal immunization of individuals before immunocompromise occurs.
AB - Although no specific infection is limited entirely to hosts with T-lymphocyte defects, certain microbial organisms have an affinity for such individuals. Effective, safe, and feasible methods are available for the prevention of two of the major life-threatening infections in patients with T-lymphocyte defects, although none of these methods is ideal. Trimethoprim-sulfamethoxazole administered orally daily or thrice weekly is highly effective for the prevention of Pneumocystis carinii pneumonia. For patients who cannot tolerate this drug combination, monthly inhalation of aerosolized pentamidine is an alternative prophylactic approach. Additional drugs in clinical or preclinical trials offer promise for use in preventing this pneumonitis. Varicella is one of the most frequent serious viral infections in patients with cancer, especially children. Varicella-zoster immune globulin (VZIG) has proven effective in reducing the frequency of infection in exposed susceptible individuals; however, breakthrough infections are not uncommon. Of 358 children with acute lymphoblastic leukemia, 62 received VZIG following exposure to varicella, and 16 (26%) of these had breakthrough varicella. A live attenuated varicella-zoster virus vaccine offers promise, especially for the universal immunization of individuals before immunocompromise occurs.
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U2 - 10.1093/clinids/17.Supplement_2.S368
DO - 10.1093/clinids/17.Supplement_2.S368
M3 - Article
C2 - 8274602
AN - SCOPUS:0027486071
SN - 1058-4838
VL - 17
SP - S368-S371
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
ER -