Antiviral treatment for preventing postherpetic neuralgia

Chen, Ning; Li, Qifu; Yang, Jie; Zhou, Muke; Zhou, Dong; He, Li

doi:10.1002/14651858.cd006866.pub3

Cited by 194 publications

(135 citation statements)

References 41 publications

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“…Administration of varicella zoster immunoglobulin (VZIG) as postexposure prophylaxis is recommended for individuals with a significant exposure to varicella or zoster, who have a clinical condition that increases their risk of severe varicella and are seronegative for VZV [22]. Use of antiviral agents such as aciclovir, valaciclovir, and famciclovir to treat zoster reduces the severity and duration of illness [35,36] but may not be associated with a reduction in post-herpetic neuralgia [37]. Developing vaccines to reduce the population burden of VZV disease has therefore been an important goal.…”

Section: Epidemiology Of Varicella and Herpes Zostermentioning

confidence: 99%

Varicella and herpes zoster vaccine development: lessons learned

Warren‐Gash

Forbes

Breuer

2017

Expert Review of Vaccines

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Introduction: Before vaccination, varicella zoster virus (VZV), which is endemic worldwide, led to almost universal infection. This neurotropic virus persists lifelong by establishing latency in sensory ganglia, where its reactivation is controlled by VZV-specific T-cell immunity. Lifetime risk of VZV reactivation (zoster) is around 30%. Vaccine development was galvanised by the economic and societal burden of VZV, including debilitating zoster complications that largely affect older individuals. Areas covered: We describe the story of development, licensing and implementation of live attenuated vaccines against varicella and zoster. We consider the complex backdrop of VZV virology, pathogenesis and immune responses in the absence of suitable animal models and examine the changing epidemiology of VZV disease. We review the vaccines’ efficacy, safety, effectiveness and coverage using evidence from trials, observational studies from large routine health datasets and clinical post-marketing surveillance studies and outline newer developments in subunit and inactivated vaccines. Expert commentary: Safe and effective, varicella and zoster vaccines have already made major inroads into reducing the burden of VZV disease globally. As these live vaccines have the potential to reactivate and cause clinical disease, developing alternatives that do not establish latency is an attractive prospect but will require better understanding of latency mechanisms.

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Section: Epidemiology Of Varicella and Herpes Zostermentioning

confidence: 99%

Varicella and herpes zoster vaccine development: lessons learned

Warren‐Gash

Forbes

Breuer

2017

Expert Review of Vaccines

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“…Therapeutic approaches include symptomatic treatments, antibiotics to treat bacterial superinfections, antiviral therapy, and nerve blocks [41]. Disease guidelines highlight the importance of beginning antiviral therapy early, if possible within 72 h from symptom onset, in order to avoid loss of efficacy [42].…”

Section: Clinical Aspects and Epidemiologymentioning

confidence: 99%

Preventing and managing herpes zoster: key actions to foster healthy aging

et al. 2015

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Population aging is the demographic phenomenon characterizing all countries in the world, and it is challenging the national infrastructures, in particular health systems. However, aging itself is not associated with increased medical spending, but disability and comorbidity that affect older individuals are the actual drivers for health expenditures. Therefore, if people age in better health, medical spending may be significantly reduced. Preventative interventions proved to be effective in reducing/preventing disease and disability and often found to be cost effective, include diet and exercise interventions, medications, routine disease screenings, and immunizations. Vaccination can protect older citizens against life-threatening diseases, such as influenza, pneumococcal infections, tetanus, and against diseases which adversely impact their quality of life, such as herpes zoster (HZ). Including HZ vaccination in its citizens' lifetime immunization calendar can reinforce Europe's commitment toward active, healthy aging. This paper outlines the consensus statement of a group of Italian experts on HZ.

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“…Proof of a positive effect of antivirals on PHN would require a randomized controlled study of patients with PHN. Most studies, however, have not found antiviral therapy to be effective in the treatment of PHN 74 and regulatory authorities do not recommend antivirals to treat this condition 75 .…”

Section: Neurological Complications Of Zostermentioning

confidence: 99%

“…Antiviral therapy should be initiated within 3 days of the onset of rash if possible, but should still be initiated if patients are seen later with continuing new lesion formation. Although antiviral therapy reduces acute pain associated with zoster, it has not been shown to reliably reduce the risk of PHN, nor is it recommended to treat established PHN 74 . Prednisone reduces acute pain and improves the ability of patients with zoster to perform activities of daily living 184 ; however, prednisone does not reduce the risk of PHN 185 and many elderly patients have conditions such as hypertension, diabetes mellitus or osteoporosis, which may preclude the use of this drug.…”

Section: Zoster and Phnmentioning

confidence: 99%