Varicella-zoster virus hepatitis and a suggested management plan for prevention of VZV infection in adult liver transplant recipients

Infection with varicella-zoster virus (VZV) is common, occurring as primary varicella, usually during childhood, and as zoster, following reactivation of latent virus. Although serious VZV infections are infrequent, they can be life-threatening when they occur in susceptible immunosuppressed patients (1, 2). These patients have a high incidence of visceral involvement, including pneumonitis, meningoencephalitis, and rarely, hepatitis. We report here 3 cases of VZV hepatitis in adult liver transplant recipients that occurred in our institution between 1984 and 1989. We describe their clinical presentations and use these cases to illustrate some aspects in diagnosis and prevention of VZV infection after solid organ Tx.