2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T5ec,Patients diagnosed with cancer are at risk of viral reactivation, namely herpes simplex virus (HSV), varicella-zoster virus (VZV) and/or cytomegalovirus (CMV). However, the risk varies significantly with underlying malignancy and treatment regimen. We review the latest evidence for antiviral prophylaxis strategies, focusing on novel immune therapies and future directions. Antiviral prophylaxis is indicated for all high-risk patients. The approval of letermovir for CMV prophylaxis has significantly reduced the burden of clinically significant infections in allogeneic hematopoietic stem cell transplant (alloHCT) recipients, and recent data now supports use up to 200 days posttransplant. For intermediate-risk regimens such as myeloma therapies and autologous hematopoietic stem cell transplant (autoHCT), antiviral prophylaxis is also a cornerstone of VZV prevention. Newer chimeric antigen receptor (CAR) T-cell and bispecific antibody (BsAb) therapies are increasingly available; while HSV/VZV prophylaxis has been incorporated into trial and real-world treatment protocols, optimal duration is unclear and data on CMV reactivation is still emerging. Solid tumours are a lower risk cohort, but high-dose steroids, immune checkpoint inhibitors and radiotherapy can increase the risk of viral reactivation and, therefore, close clinical monitoring is warranted. As the cancer treatment landscape evolves, ongoing research into optimal antiviral prophylaxis approaches is necessary to improve patient outcomes.31:T7ab, Purpose of review Patients diagnosed with cancer are at risk of viral reactivation, namely herpes simplex virus (HSV), varicella-zoster virus (VZV) and/or cytomegalovirus (CMV). However, the risk varies significantly with underlying malignancy and treatment regimen. We review the latest evidence for antiviral prophylaxis strategies, focusing on novel immune therapies and future directions. Recent findings Antiviral prophylaxis is indicated for all high-risk patients. The approval of letermovir for CMV prophylaxis has significantly reduced the burden of clinically significant infections in allogeneic hematopoietic stem cell transplant (alloHCT) recipients, and recent data now supports use up to 200 days posttransplant. For intermediate-risk regimens such as myeloma therapies and autologous hematopoietic stem cell transplant (autoHCT), antiviral prophylaxis is also a cornerstone of VZV prevention. Newer chimeric antigen receptor (CAR) T-cell and bispecific antibody (BsAb) therapies are increasingly available; while HSV/VZV prophylaxis has been incorporated into trial and real-world treatment protocols, optimal duration is unclear and data on CMV reactivation is still emerging. Solid tumours are a lower risk cohort, but high-dose steroids, immune checkpoint inhibitors and radiotherapy can increase the risk of viral reactivation and, therefore, close clinical monitoring is warranted. Summary As the cancer treatment landscape evolves, ongoing research into optimal antiviral prophylaxis approaches is necessary to improve patient outcomes. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Varicella-Zoster Virus Infection: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Varicella-Zoster Virus Infection (condition). Clinician-written summaries and actionable practice insights. 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Studies largely involve only the live attenuated zoster vaccine, limiting generalizability to the recombinant subunit vaccine. Longitudinal immune phenotyping and blood-based biomarker data are lacking.","practice_takeaway":"Current evidence supports a probable protective signal between zoster vaccination and dementia risk, though mechanism is unproven. Clinicians should continue recommending zoster vaccination per existing guidelines while awaiting mechanistic and prospective trial data."}},{"doi":"10.1097/qco.0000000000001198","pmid":"42068587","title":"Antiviral prophylaxis against herpesviruses (herpes simplex virus, varicella-zoster virus and cytomegalovirus) among patients with cancer","journal_title":"Current Opinion in Infectious Diseases","journal_issn":"0951-7375","published_at":"2026-05-03T00:00:00.000Z","url":"https://doi.org/10.1097/qco.0000000000001198","source_score":30,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-08","doi":"10.1097/qco.0000000000001198","days":"7","issn":"0951-7375","rank":"3","field":"Clinical Medicine","score":"30","category":"Infectious Diseases","categories":["Infectious Diseases"],"_categories":["Infectious Diseases"]},"pubmed":{"doi":"10.1097/QCO.0000000000001198","title":"Antiviral prophylaxis against herpesviruses (herpes simplex virus, varicella-zoster 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Review","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001198","tag_type":"warning","value":"Age group tagged as 'adult' based on typical oncology/transplant populations described; pediatric patients are not explicitly addressed in the abstract.","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001198","tag_type":"warning","value":"Letermovir brand name 'Prevymis' inferred from clinical knowledge; not explicitly stated in the abstract.","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001198","tag_type":"warning","value":"The full article text was not accessible — only the abstract was retrieved. All summary content is derived from the abstract alone; specific study data, patient populations, and outcome numbers were not verifiable.","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001198","tag_type":"warning","value":"The PDF content extracted appears to be a Lippincott author permissions document, not the article itself, suggesting the full text was unavailable or incorrectly attached.","value_numeric":null}],"summaries":{"what_studied":"This review evaluates antiviral prophylaxis strategies against HSV, VZV, and CMV in cancer patients, with a focus on novel immune therapies including CAR T-cell therapy, bispecific antibodies, and evolving regimens for alloHCT, autoHCT, and solid tumors.","key_result":"Letermovir has significantly reduced clinically significant CMV infections in alloHCT recipients, with recent data supporting extended use up to 200 days post-transplant; HSV/VZV prophylaxis is now standard in CAR T-cell and bispecific antibody protocols, though optimal duration remains undefined and CMV reactivation data in these settings is still emerging.","limitations":"The full text of the article was not extractable — only the abstract was available; specific study-level data, patient numbers, and comparative outcomes could not be verified from the source. This is a narrative review, so the level of evidence is inherently lower than a systematic review or meta-analysis.","practice_takeaway":"Extend letermovir CMV prophylaxis to 200 days post-alloHCT when supported by institutional protocols, and incorporate HSV/VZV prophylaxis into CAR T-cell and bispecific antibody regimens. Monitor solid tumor patients closely for viral reactivation when high-dose steroids, immune checkpoint inhibitors, or radiotherapy are used."}}],"initialOffset":2,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Varicella-Zoster Virus Infection"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Varicella-Zoster Virus Infection"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Varicella-Zoster Virus Infection"}}}]]

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