Recommendations for the Management of Herpes Zoster

Utrecht University, Utrecht, Utrecht, Netherlands
Clinical Infectious Diseases (Impact Factor: 8.89). 02/2007; 44 Suppl 1(Supplement 1):S1-26. DOI: 10.1086/510206
Source: PubMed


The objective of this article is to provide evidence-based recommendations for the management of patients with herpes zoster
(HZ) that take into account clinical efficacy, adverse effects, impact on quality of life, and costs of treatment. Systematic
literature reviews, published randomized clinical trials, existing guidelines, and the authors' clinical and research experience
relevant to the management of patients with HZ were reviewed at a consensus meeting. The results of controlled trials and
the clinical experience of the authors support the use of acyclovir, brivudin (where available), famciclovir, and valacyclovir
as first-line antiviral therapy for the treatment of patients with HZ. Specific recommendations for the use of these medications
are provided. In addition, suggestions are made for treatments that, when used in combination with antiviral therapy, may
further reduce pain and other complications of HZ.

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    • "per 1,000 person/year among those older than 65 years, and incidence rates worldwide are similar [13] [14]. This relationship with age has been demonstrated in many geographical areas [13] [14] [15] [16] [17] [18] and is attributed to the fact that cellular immunity declines as people grow older. In our study patients' age was between 36.2 and 76.4 years with average of 56.3 years. "
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    ABSTRACT: Background. Herpes zoster infection is a painful worldwide disease. Inappropriate and delayed treatment causes prolongation of the disease with debilitating symptoms and postherpetic neuralgia. Method. A cross-sectional study evaluated shingles cases admitted in a teaching hospital with one-year followup in north of Iran from 2007 to 2013. Results. From 132 patients, 60.4% were male. Head and neck involvement occurred in 78 people (59.1%), thoracoabdominal region in 37 cases (28%), and extremities in 16 cases (12.1%), and one case (0.8%) got multisites involvement. 54 cases (40.9%) had predisposing factors including diabetes mellitus in 26 cases (19.7%), malignancy in 15 (11.4%), immunosuppressive medication in 7 (5.03%), HIV infection in 3 (2.3%), radiotherapy in 2 (1.5%), and tuberculosis in one patient (0.8%). The most common symptoms were pain (95.5%), weakness (56%), fever (31.1%), headache (30.3%), ocular complaints (27.3%), itching (24.2%), and dizziness (5.3%). 21 cases (15.9%) had bacterial superinfection on blistering areas and overall 18 cases (13.6%) had opium addiction. 4 cases (3.03%) died during admission because of comorbidities. Postherpetic neuralgia was reported in 56 patients (42.5%) after three months and seven cases (5%) in one-year followup. Conclusion. Shortening interval between skin lesion manifestation and starting medication can accelerate lesion improvement and decrease disease course, extension, and complication.
    Full-text · Article · Mar 2015 · Neurology Research International
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    • "Ainsi, une sensation douloureuse ou un prodrome sensitif (pas toujours présent) ; respectant un dermatome ; suivi d'une éruption de vésicules groupées (cependant, dans certains cas, seule une papule peut être observée) ; en l'absence d'éruption identique dans le(s) même(s) dermatome(s) (pour exclure une récurrence d'un HSV) ; associées à une douleur et/ou une allodynie dans le territoire de l'éruption, sont les caractéristiques pathognomoniques de l'éruption associée au zona [11]. Cependant, selon les données issues de l'étude de prévention du zona par la vaccination, et de séries de confrontation clinicobiologiques, il apparaît respectivement que 20 % des suspicions diagnostiques n'ont pas été confirmées par polymerase chain reaction (PCR) [6] et que, d'une façon générale, sur 10 % des prélèvements effectués sur des cas présumés de zona étaient en réalité isolés de l'HSV [11]. Ainsi en présence de lésions atypiques (cf. "

    Full-text · Dataset · Dec 2014
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    • "Tabrizi R., et al. 113 als) of herpes zoster ranges from 1.2 to 3.4 in young patients and 3.9–11.8 in patients older than 65 years [5]. Antiviral drug therapy can reduce the severity and duration of herpes zoster if the administration of these drugs is started within 72 hours from the initial presence of the characteristic skin rash and is continued for 7-10 days [5] [6]. The thoracolumbar trunk (especially T3 to L3) is most commonly involved in HZ infection(HZI) [7]. "
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    ABSTRACT: Statement of the Problem: Alveolar bone necrosis induced by Herpes zoster infection is considered as a rare manifestation of osteomyelitis and few case reports are presented in the literature. Purpose: The aim of this study was to evaluate mandibular osteomyelitis caused by herpes zoster in the immunocompromised patients with histopathologically documented osteomyelitis in the mandible and herpes zoster infection. Materials and Method: 30 patients were recruited in this cross-sectional study. 19 patients were completely edentulous, 4 patients were partially edentulous and 7 with complete dentition. In all cases, specimens were analyzed using a conventional polymerase chain reaction (PCR) test for varicella zoster virus. Results: 16 patients underwent dialysis, 9 patients received chemotherapy treatments and 5 patients had transplantation (four kidneys and one liver). Histopathological assessment demonstrated a nonspecific bone necrosis exhibiting an eosinophilic, homogeneous non-vital bone tissue with peripheral resorption surrounded by reactive connective tissue. PCR test was positive in 21 cases. Conclusion: This study demonstrated that the frequency of osteomyelitis induced by herpes zoster could be more than the records provided by previous studies. Histopathological findings might be nonspecific in such patients. PCR test was not positive for all HZ induced osteomyelitis patients.
    Full-text · Article · Sep 2014
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