Miriam Wittek

Publications (6)5.55 Total impact

• Article: Varizellen und Herpes zoster

  Miriam Wittek, Hans Wilhelm Doerr, Regina Allwinn
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  ABSTRACT: Das Varicella-Zoster-Virus (VZV) gehört zu den acht bisher bekannten Herpesviren des Menschen, zeigt ein ubiquitäres Vorkommen und verursacht die akute exanthematöse Kinderkrankheit „Windpocken“. Typisch ist der hohe Kontagiositätsindex. Die Hauptübertragung erfolgt über Aerosole, seltener über direkten Kontakt mit Bläschenflüssigkeit. Eine Eigenschaft aller Herpesviren ist ihre Latenz. Nach der Primärinfektion wandert das Virus retrograd mit dem Zytoplasmastrom der Neurone zum Spinalganglion. Das Virusgenom verbleibt dort latent, weitgehend inaktiv im Kern der Spinalganglienzelle. Reaktivierungen sind bei allen latent Infizierten möglich. Gewöhnlich werden Reaktivierungen im höheren Alter (> 50 Jahre) sowie bei Abfall der Gedächtniszellen für die T-Lymphozyten beobachtet. Gerade bei älteren Menschen und Risikogruppen (Immunsupprimierte) werden im Zusammenhang mit Reaktivierungen schwere Krankheitsverläufe beschrieben. Eine häufig auftretende und schwer behandelbare Komplikation stellt die postzosterische Neuralgie (PZN) dar, ein neuropathischer Schmerz, der definitionsgemäß > 6 Wochen nach dem akuten Infekt persistiert und eine adäquate antivirale Therapie und Schmerzbehandlung erfordert. Varicella-zoster virus (VZV), known as one of the eight human herpesviridae, shows a ubiquitous distribution and is the cause for acute exanthema in childhood (chickenpox). VZV is highly infectious, spread by respiratory droplets and direct contact with fluid in vesicles. As a characteristic of the α-herpesviridae, VZV establishes latency in the nucleus of the paraspinal cells. Reactivation of VZV (zoster) is possible in all infected persons, but becomes more common with increasing age and a decline of VZV-specific cell-mediated immunity. Immunocompromised patients and older people (> 50 years) have an increased risk for a severe course of disease. The postherpetic neuralgia (PHN), as one of the most common and feared complications, is defined as a neuropathic pain (burning character), which persists for > 6 weeks after onset of disease and needs adequate antiviral and pain treatment. Schlüsselwörter: VZV-Epidemiologie-Postzosterische Neuralgie-VZV-Diagnostik Key Words: VZV epidemiology-Postherpetic neuralgia-VZV diagnostics
  04/2012; 105(5):334-338.
• Article: [Varicella and herpes zoster. Part 2: therapy and prevention].

  Miriam Wittek, Hans Wilhelm Doerr, Regina Allwinn
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  ABSTRACT: In Germany, five antiviral agents are approved for antiviral therapy in zoster patients (acyclovir, valacyclovir, famciclovir, brivudine, and foscarnet). They should be administered within 72 h after rash onset and can significantly shorten viral replication and reduce the complications. In 2004, the German Standing Committee on Vaccination (STIKO) at the Robert Koch Institute suggested the active immunization against varicella with a live attenuated varicella vaccine (Oka strain) for all children and young persons. The first dose is given between the ages of 11 and 14 months, the second at the earliest 4 weeks later. Passive immunization is indicated as postexposure prophylaxis in high-risk individuals within 72-96 h after exposure. High-risk individuals are pregnant women, immunocompromised patients, or newborns, whose mothers had a primary varicella infection 5 days before or 2 days after birth. The Shingles Prevention Study demonstrated that vaccination is the most effective strategy for prevention of herpes zoster and postherpetic neuralgia.
  Medizinische Klinik 06/2010; 105(6):399-403. · 0.34 Impact Factor
• Article: [Varicella and herpes zoster. Part 1: virology, epidemiology, clinical picture, laboratory diagnostics].

  Miriam Wittek, Hans Wilhelm Doerr, Regina Allwinn
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  ABSTRACT: Varicella-zoster virus (VZV), known as one of the eight human herpesviridae, shows a ubiquitous distribution and is the cause for acute exanthema in childhood (chickenpox). VZV is highly infectious, spread by respiratory droplets and direct contact with fluid in vesicles. As a characteristic of the alpha-herpesviridae, VZV establishes latency in the nucleus of the paraspinal cells. Reactivation of VZV (zoster) is possible in all infected persons, but becomes more common with increasing age and a decline of VZV-specific cell-mediated immunity. Immunocompromised patients and older people (> 50 years) have an increased risk for a severe course of disease. The postherpetic neuralgia (PHN), as one of the most common and feared complications, is defined as a neuropathic pain (burning character), which persists for > 6 weeks after onset of disease and needs adequate antiviral and pain treatment.
  Medizinische Klinik 05/2010; 105(5):334-8. · 0.34 Impact Factor
• Source

  Available from: krankenhaus-frankfurt.de

  Article: Laboratory diagnosis of myocarditis and pericarditis. Part II: virologic investigations 1

  Miriam Wittek, Gudrun Hintereder, Regina Allwinn, Klaus-Peter Hunfeld, Hans Wilhelm Doerr
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  ABSTRACT: Viral infections are the most common cause of myocarditis in Europe. Although the symptoms of pericarditis are often non-ambiguous, the diagnosis of ''myocarditis'' can be dif-ficult in terms of clinical presentation and different testing methods used for confirmation. Immunohistochemical tech-niques for characterization and quantification of inflamma-tory heart tissue reactions as well as molecular methods for viral genome detection are applied. The viral testing methods are described and their advantages and limitations are discussed.
  J Lab Med. 01/2010; 34.
• Source

  Available from: krankenhaus-frankfurt.de

  Article: Laboratory diagnosis of myocarditis and pericarditis. Part I: Microbiologic investigations 1

  Miriam Wittek, Gudrun Hintereder, Regina Allwinn, Hans Wilhelm Doerr, Klaus-Peter Hunfeld
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  ABSTRACT: Inflammatory disorders of the heart can be classified as myo-carditis, pericarditis or endocarditis. Myocarditis is an acute or chronic inflammation affecting the myocardium. Next to viral infections bacterial pathogens represent the most impor-tant cause of myocarditis in Europe and North America. Dif-ferent bacterial, fungal and parasite agents also play an important role in the pathophysiology of inflammatory heart disorders. In addition to infectious agents, a wide variety of toxins and drugs (e.g., cocaine«) and some chronic auto-immune diseases (lupus) also have the ability to cause myo-carditis. Clinical features of acute or chronic myocarditis are often non-specific, ranging from mild to life-threatening symptoms (sudden cardiac death, chronic heart failure«). In 25% of cases, myocarditis is associated with a pericardial infection. Many isolated pericarditis cases are seen during disseminated purulent bacterial infections and tuberculosis.
  J Lab Med. 01/2010; 34.
• Article: Molecular assays for monitoring HIV infection and antiretroviral therapy.

  Miriam Wittek, Martin Stürmer, Hans Wilhelm Doerr, Annemarie Berger
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  ABSTRACT: Infection with HIV results in lifelong persistence of the virus in the body of infected persons, independent of antiretroviral treatment. Therefore, efficient and meaningful therapy monitoring has been developed since its introduction in the 1980s. Whereas, primarily, the measurement of the CD4 cell count was the most important clinical marker of disease progression, nowadays the estimation of plasma viral load with molecular methods plays a major role as a marker of therapy success. To optimize therapy changes in patients failing on antiretroviral therapy regimen, HIV-1 genotyping has been introduced and is now widely accepted as an additional diagnostic tool. Due to this increase in diagnostic parameters, clinicians and virologists have to cope with many different methods. This review should give a brief overview of the current commercially available assays for detection and quantification of HIV, as well as for HIV-1 genotypic resistance testing. Quantitative reverse transcriptase PCR, real-time PCR, nucleic acid sequence-based amplification and the branched DNA system are described in detail, and the advantages and disadvantages are discussed. In addition, two commercially available HIV-1 genotyping assays are compared. However, a general recommendation to favor one system over the other cannot be given, because the final decision of which system to use should be decided on the individual requirements.
  Expert Review of Molecular Diagnostics 06/2007; 7(3):237-46. · 4.86 Impact Factor