Postexposure chickenpox prophylaxis in children with leukaemia: a reply to the recent PEPtalk study and report of a service evaluation in a tertiary paediatric haematology centre in the UK

The impact of varicella zoster virus (VZV) exposure and disease among our patients, as well as implications on use of hospital resources, may therefore have been significantly underestimated by Bate and his group. Comparison of these rates of clinical disease following acyclovir prophylaxis are similar to those reported following VZIG (22% vs 21% respectively), with severe and even fatal cases reported following the use of both forms of prophylaxis. 2 It is our understanding (further supported by the PEPtalk study) that there is no available evidence for inferiority of acyclovir compared with VZIG for PEP of chickenpox in immunocompromised children.