抄録
In this study,we evaluated the prophylactic effect of acyclovir against infectious diseases due to the herpes simplex virus (HSV) and varicella zoster virus (VZV) after bone marrow transplantation in consideration of the results of 9 randomized placebo-controlled trials.Based on the number of infections during dosing,acyclovir significantly reduced HSV infectious diseases (risk difference[RD],-0.39 ; 95% confidence interval[CI],-0.49 to -0.30 ; P <0.0001)and VZV infectious diseases (RD,-0.18 ; 95% CI,-0.26 to -0.10 ; P <0.0001).From a count of patients with infectious diseases during and after dosing,RDs were estimated to be -0.14 (95% CI,-0.24 to -0.04 ; P =0.0054)and -0.02 (95% CI,-0.14 to 0.10 ; P = 0.7175)for HSV and VZV,respectively.
A cumulative meta-analysis showed that the addition of data from new studies increased the RD of HSV infectious diseases during dosing from -0.50 (95% CI,-0.81 to -0.19)to -0.39.On the other hand,the RD estimated from patients infected both during and after dosing fell from -0.10 (95% CI,-0.48 to 0.28)to -0.14,and with the addition of data from studies published after 1987,the prophylactic effect of acyclovir against HSV infectious diseases became statistically significant.
These findings show that the prophylactic effect of acyclovir against HSV infectious diseases is statistically significant both during and after dosing in bone marrow transplant patients,and that its effect on VZV infectious diseases is limited to the dosing period.
