Incidence and Management of Early Breakthrough HSV Infection Among Allogeneic Hematopoietic Stem Cell Transplant Recipients

The study examined the incidence of herpes simplex virus (HSV) in patients during the first 100 days after allogeneic hematopoietic stem cell transplantation despite antiviral prophylaxis. Patients from 2002 to 2022 were analyzed, totaling 4,357 patients aged 18 years and older, of whom 86 percent were HSV seropositive. Breakthrough HSV infection developed in only 23 patients (0.6 percent). The median time from transplantation to the first positive test was 46 days. The most common sites of infection were oral and genital mucosa. In 47.8 percent of patients with breakthrough HSV infection, resistant or refractory infection developed. The results confirm the high effectiveness of universal antiviral prophylaxis in the early post-transplant period.