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Varicella-zoster Virus (varicella-zoster + virus)
Selected AbstractsEpidemiology of varicella-zoster virus in England and WalesJOURNAL OF MEDICAL VIROLOGY, Issue S1 2003M. Brisson Abstract Many countries are studying currently the possibility of mass vaccination against varicella. The objective of this study was to provide a complete picture of the pre-vaccine epidemiology of the Varicella-Zoster Virus in England and Wales to aid in the design of immunisation programs. Population-based data including general practitioner sentinel surveillance, hospitalisation data, and death certificates from England and Wales were analysed. The average incidence rates for varicella and zoster between 1991 and 2000 were 1,291 and 373 per 100,000 years, respectively. Overall hospitalisation rates were equal for varicella and zoster (4.5 vs. 4.4 hospitalisation per 100,000 population) with 5 and 8%, respectively, having underlying immunosuppressive conditions. The age-specific proportion of cases hospitalised and length of stay were similar between the two diseases. However, the overall burden of disease is considerably higher for zoster. The number of inpatient days and case-fatality due to zoster are roughly 4 to 6 times greater than for varicella (11 vs. 3 days and 25 vs. 4 deaths per 100,000 case). These results provide base-line estimates should mass varicella vaccination be introduced in England and Wales. J. Med. Virol. 70:S9,S14, 2003. © 2003 Wiley-Liss, Inc. [source] Varicella-Zoster virus: Virology and clinical managementANNALS OF NEUROLOGY, Issue 3 2001Catherine Amlie-Lefond MD No abstract is available for this article. [source] Use of a rodent model to show that varicella-zoster virus ORF61 is dispensable for establishment of latency,JOURNAL OF MEDICAL VIROLOGY, Issue S1 2003Hitoshi Sato Abstract Varicella-zoster virus (VZV) results in a latent infection in humans after primary infection. Latency has also been established in guinea pigs and rats after inoculation with the virus. It was found that infection of cotton rats with the Oka vaccine strain of VZV results in a latent infection. To begin to identify which genes are required for latency, we infected cotton rats with VZV strain Oka that is deleted for ORF61. ORF61 protein transactivates certain VZV promoters and enhances the infectivity of viral DNA in transient transfections. Deletion of ORF61 results in abnormal syncytia and impairs the growth of VZV in vitro. Inoculation of cotton rats with ORF61-deleted Oka virus resulted in latent VZV infection in the nervous system similar to that seen for animals infected with parental virus. Thus, the cotton rat can be used to study the ability of mutants in the Oka vaccine strain of VZV to establish latent infection. J. Med. Virol. 70:S79,S81, 2003. © 2003 Wiley-Liss, Inc. [source] Varicella-zoster virus isolates, but not the vaccine strain OKA, induce sensitivity to alpha-1 and beta-1 adrenergic stimulation of sensory neurones in cultureJOURNAL OF MEDICAL VIROLOGY, Issue S1 2003Michaela Schmidt Abstract The reactivation of varicella-zoster virus (VZV) from its persistent state in sensory neurones causes shingles and induces severe, long-lasting pain and hyperalgesia that often lead to postherpetic neuralgia. To investigate the VZV-induced neuropathic changes, we established conditions for the active infection of sensory neurones from rat dorsal root ganglia in vitro. After 2 days of culture, up to 50% of the cells expressed viral antigens of the immediate-early and late replication phase. The intracellular calcium ion concentration was monitored in individual cells by microfluorimetry. Whereas the calcium response to capsaicin was preserved, the VZV-infected neurones gained an unusual sensitivity to noradrenaline stimulation in contrast to non-infected cells. The adrenergic agonists phenylephrine and isoproterenol had a similar efficacy demonstrating that both ,1 - and ,1 -adrenoreceptors were involved. The sensitivity to adrenergic stimulation was observed after infection with different wildtype isolates, but not with the attenuated vaccine strain OKA. The lack of noradrenaline sensitivity of vaccine-infected neurones demands a structural comparison of wildtype and vaccine viruses with and without phenotype. A partial sequence evaluation (26 kb) of the European OKA vaccine strain surprisingly revealed a series of nucleotide exchanges in comparison to presumably identical OKA strains from other sources, although VZV is generally considered genetically stable. In summary, we report that the infection with wildtype VZV isolates, but not with the vaccine strain, induces noradrenaline sensitivity in sensory neurones, which correlates with clinical and experimental observations of adrenergic effects involved in VZV-induced neuralgia. J. Med. Virol. 70:S82,S89, 2003. © 2003 Wiley-Liss, Inc. [source] Varicella-zoster virus infection in adult patients after unrelated cord blood transplantation: a single institute experience in JapanBRITISH JOURNAL OF HAEMATOLOGY, Issue 5 2003Akira Tomonari Summary. Varicella-zoster virus (VZV) infection was studied in 40 adult patients who underwent cord blood transplantation (CBT) from unrelated donors. Twenty-five patients developed VZV reactivation at a median of 5 months after CBT (range 1·7,26 months). The cumulative incidence of VZV reactivation after CBT was 80% at 30 months. Twenty-two patients developed localized herpes zoster. The remaining three patients developed atypical non-localized herpes zoster, which was associated with visceral dissemination in one patient. All the patients responded well to antiviral therapy. Unexpectedly, the absence of grade II,IV acute graft-versus-host disease (GVHD) was associated with a higher rate of VZV reactivation after CBT (100% versus 55%, P = 0·01). These results suggest that recovery of VZV-specific immune responses after CBT is delayed even in patients without severe acute GVHD. [source] Cutaneous infections in the elderly: diagnosis and managementDERMATOLOGIC THERAPY, Issue 3 2003Jeffrey M. Weinberg ABSTRACT:, Over the past several years there have been many advances in the diagnosis and treatment of cutaneous infectious diseases. This review focuses on the three major topics of interest in the geriatric population: herpes zoster and postherpetic neuralgia (PHN), onychomycosis, and recent advances in antibacterial therapy. Herpes zoster in adults is caused by reactivation of the varicella-zoster virus (VZV) that causes chickenpox in children. For many years acyclovir was the gold standard of antiviral therapy for the treatment of patients with herpes zoster. Famciclovir and valacyclovir, newer antivirals for herpes zoster, offer less frequent dosing. PHN refers to pain lasting ,2 months after an acute attack of herpes zoster. The pain may be constant or intermittent and may occur spontaneously or be caused by seemingly innocuous stimuli such as a light touch. Treatment of established PHN through pharmacologic and nonpharmacologic therapy will be discussed. In addition, therapeutic strategies to prevent PHN will be reviewed. These include the use of oral corticosteroids, nerve blocks, and treatment with standard antiviral therapy. Onychomycosis, or tinea unguium, is caused by dermatophytes in the majority of cases, but can also be caused by Candida and nondermatophyte molds. Onychomycosis is found more frequently in the elderly and in more males than females. There are four types of onychomycosis: distal subungual onychomycosis, proximal subungual onychomycosis, white superficial onychomycosis, and candidal onychomycosis. Over the past several years, new treatments for this disorder have emerged which offer shorter courses of therapy and greater efficacy than previous therapies. The treatment of bacterial skin and skin structure infections in the elderly is an important issue. There has been an alarming increase in the incidence of gram-positive infections, including resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and drug-resistant pneumococci. While vancomycin has been considered the drug of last defense against gram-positive multidrug-resistant bacteria, the late 1980s saw an increase in vancomycin-resistant bacteria, including vancomycin-resistant enterococci (VRE). More recently, strains of vancomycin-intermediate resistant S. aureus (VISA) have been isolated. Gram-positive bacteria, such as S. aureus and Streptococcus pyogenes are often the cause of skin and skin structure infections, ranging from mild pyodermas to complicated infections including postsurgical wound infections, severe carbunculosis, and erysipelas. With limited treatment options, it has become critical to identify antibiotics with novel mechanisms of activity. Several new drugs have emerged as possible therapeutic alternatives, including linezolid and quinupristin/dalfopristin. [source] Treatment of varicella-zoster virus and postherpetic neuralgiaDERMATOLOGIC THERAPY, Issue 3 2000Daniel A. Carrasco ABSTRACT: Chickenpox is mostly a disease of childhood; shingles usually affects the elderly, but any age group may be afflicted. Although several proved pharmacologic agents are known to be efficacious in the acute phase of varicella-zoster infections, only three are FDA approved for use in immunocompetent zoster patients and one for the use in primary varicella infections. Ongoing studies with immunocompromised patients are determining whether higher doses of newer oral antivirals will be effective. While a cure for postherpetic neuralgia has not been found, effective treatment to reduce its duration and severity means early implementation of newer antiviral agents. While corticosteroids do not prevent postherpetic neuralgia, they do improve the quality of life when used in combination with acyclovir. Often, symptomatic relief with narcotics, topical anesthetics, and tricyclic antidepressants are necessary. [source] Safety and Immunogenicity Profile of the Concomitant Administration of ZOSTAVAX and Inactivated Influenza Vaccine in Adults Aged 50 and OlderJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2007Boris Kerzner MD OBJECTIVES: To evaluate the safety and immunogenicity of ZOSTAVAX administered concomitantly with inactivated influenza vaccine or sequentially in adults aged 50 and older. DESIGN: Randomized, blinded, placebo-controlled study. SETTING: Thirteen U.S. and seven European study sites. PARTICIPANTS: Three hundred eighty-two concomitantly, 380 sequentially vaccinated subjects. INTERVENTION: The concomitant vaccination group received influenza vaccine and ZOSTAVAX at separate injection sites on Day 1 and placebo at Week 4. The nonconcomitant vaccination group received influenza vaccine and placebo at separate injection sites on Day 1 and ZOSTAVAX at Week 4. MEASUREMENTS: Primary safety endpoints: vaccine-related serious adverse experiences (AEs) within 28 days postvaccination (PV); and diary card,prompted local and systemic AEs. Primary immunogenicity endpoints: geometric mean titer (GMT) and geometric mean fold rise (GMFR) from baseline of varicella-zoster virus (VZV) antibody (Ab) at 4 weeks PV according to glycoprotein enzyme-linked immunosorbent assay (gpELISA) and GMT of influenza Ab for the three vaccine strains (2005,2006 influenza season) at 4 weeks PV according to hemagglutination inhibition assay. Secondary immunogenicity endpoint: influenza seroconversion rates (SCRs). RESULTS: No serious AEs related to ZOSTAVAX were observed during the study. VZV Ab GMTs 4 weeks PV for the concomitant and sequential groups were 554 and 597 gpELISA U/mL, respectively. The estimated VZV Ab GMT ratio was 0.9 (95% confidence interval (CI)=0.8,1.0), indicating noninferior (P<.001 for the null hypothesis of GMT ratio <0.67) responses. Estimated VZV Ab GMFR from baseline in the concomitant group was 2.1 (95% CI=2.0,2.3), indicating acceptable fold rise. Estimated GMT ratios (concomitant/sequential) for influenza strains A(H1N1), A(H3N2), and B were 0.9 (95% CI=0.8,1.1), 1.1 (95% CI=0.9,1.3), and 0.9 (95% CI=0.8,1.1), respectively, and SCRs were comparable across both groups, with more than 85% achieving titers of 1:40 or greater, meeting regulatory criteria. CONCLUSION: ZOSTAVAX and influenza vaccine given concomitantly are generally well tolerated in adults aged 50 and older. Ab responses were similar whether ZOSTAVAX and influenza vaccine were given concomitantly or sequentially. [source] Prevalence of persistent and latent viruses in untreated patients infected with HIV-1 from Ghana, West AfricaJOURNAL OF MEDICAL VIROLOGY, Issue 11 2009Lara Isobel Compston Abstract Only limited epidemiological data, pertaining to the prevalence of common persistent viruses has been reported in Ghana. This study was conducted to determine the prevalence of persistent viruses in individuals with untreated HIV-1 infection and uninfected blood donors. Paired plasma and cellular samples from HIV-negative blood donors, asymptomatic HIV and symptomatic/AIDS cohorts were screened by multiplex PCR then qPCR for parvovirus B19 (B19V), hepatitis B virus (HBV), GB virus-C (GBV-C), cytomegalovirus (CMV), Epstein,Barr virus (EBV), human herpesvirus-8 (HHV-8) and varicella-zoster virus (VZV). IgG antibodies specific to each target virus were tested to determine exposure rates. No evidence of viraemia was found for B19V and VZV in any group. Prevalence of GBV-C plasma viraemia was significantly higher in asymptomatic and symptomatic HIV infection (16.7%) and (16.2%) than in blood donors (4%) P,<,0.005. Occult HBV infection was significantly more frequent in symptomatic HIV infection (10.9%) compared to asymptomatic HIV (3.6%) and blood donors (1.6%) P,<,0.005. Although there was a high background of EBV viraemia in cellular fractions of blood donors (8.3%), it was significantly higher in asymptomatic (44.6%) and symptomatic HIV (14.6%) P,<,0.0001. For CMV, the significantly increased prevalence of viraemia was only observed in the plasma fraction of the symptomatic HIV-1/AIDS patients (7.6%) compared to asymptomatic individuals (1.8%) and blood donors (0.8%) P,,,0.001. The background seroprevalence in blood donors was high for B19V (,64%), HBV (,70%), CMV and EBV (,90%) and was significantly increased in HIV infections for HBV, CMV, VZV (symptomatic HIV), and HHV-8 (asymptomatic and symptomatic HIV). J. Med. Virol. 81:1860,1868, 2009. © 2009 Wiley-Liss, Inc. [source] Prevalence of human papilloma virus and human herpes virus types 1,7 in human nasal polyposisJOURNAL OF MEDICAL VIROLOGY, Issue 9 2009Apostolos Zaravinos Abstract This study aimed to investigate the prevalence of human papilloma virus (HPV), herpes simplex virus-1/-2 (HSV-1/-2), varicella-zoster virus (VZV), Epstein,Barr virus (EBV), cytomegalovirus (CMV), and human herpes virus-6/-7 (HHV-6/-7) in 23 human nasal polyps by applying PCR. Two types of control tissues were used: adjacent inferior/middle turbinates from the patients and inferior/middle turbinates from 13 patients undergoing nasal corrective surgery. EBV was the virus most frequently detected (35%), followed by HPV (13%), HSV-1 (9%), and CMV (4%). The CMV-positive polyp was simultaneously positive for HSV-1. HPV was also detected in the adjacent turbinates (4%) and the adjacent middle turbinate (4%) of one of the HPV-positive patients. EBV, HSV, and CMV were not detected in the adjacent turbinates of the EBV-, HSV- or CMV-positive patients. All mucosae were negative for the VZV, HHV-6, and HHV-7. This is the first study to deal with the involvement of a comparable group of viruses in human nasal polyposis. The findings support the theory that the presence of viral EBV markedly influences the pathogenesis of these benign nasal tumors. The low incidence of HPV detected confirms the hypothesis that HPV is correlated with infectious mucosal lesions to a lesser extent than it is with proliferative lesions, such as inverted papilloma. The low incidence of HSV-1 and CMV confirms that these two herpes viruses may play a minor role in the development of nasal polyposis. Double infection with HSV-1 and CMV may also play a minor, though causative, role in nasal polyp development. VZV and HHV-6/-7 do not appear to be involved in the pathogenesis of these mucosal lesions. J. Med. Virol. 81:1613,1619, 2009. © 2009 Wiley-Liss, Inc. [source] Genotypes of varicella-zoster virus wild-type strains in GermanyJOURNAL OF MEDICAL VIROLOGY, Issue 6 2008A. Sauerbrei Abstract Surveillance of varicella-zoster virus (VZV) genotypes is indicated in Germany after implementation of universal varicella vaccination. This article reports genotyping data of 77 VZV strains obtained from 54 patients with varicella, 1 newborn with congenital varicella syndrome, 2 fetuses with intrauterine VZV infection and 20 cases with zoster. Fragments of the open reading frames (ORF) 1, 21, 22, 37, 50, 54, and 60 were analyzed by sequencing. In addition, the PstI polymorphism of the ORF 38 was characterized. Thirty strains, 22 from varicella and 8 from zoster, had the genetic markers of genotype E2, 2 of them carried new single nucleotide polymorphisms (SNP). Twenty-nine VZV isolates, 17 from varicella, and 12 from zoster, could be analyzed as E1 strains, 6 of them as E1 variants containing individual SNPs. Finally, 17 strains taken from primary VZV infection were classified as genotype M1, 13 of which belonged to the M1 subtype 1, 3 to the M1 subtype 2, and 1 to the M1 subtype 3. One strain was regarded as potential E2/J recombinant. In conclusion, VZV genotypes E2, E1, and M1 can be found in nearly equal incidence in varicella in Germany. The most frequent group is attributed to the genotype E2. Genotype M1 strains can only be detected after primary VZV infection and not in zoster cases. The possible recombinant could not be classified definitely by the scattered SNP method used and, therefore, has to be confirmed by full-genome sequencing studies. J. Med. Virol. 80:1123,1130, 2008. © 2008 Wiley-Liss, Inc. [source] Pathogenesis of simian varicella virusJOURNAL OF MEDICAL VIROLOGY, Issue S1 2003Wayne L. Gray Abstract Simian varicella virus (SVV) is closely related to varicella-zoster virus (VZV) and induces a natural varicella-like disease in nonhuman primates. Therefore, simian varicella is a useful model to investigate varicella pathogenesis and to evaluate antiviral therapies. In this report, we review recent studies on SVV pathogenesis and latency. Experimental infection of African green monkeys is followed by a 7,10 day incubation period during which a viremia disseminates the virus throughout the body. Clinical disease is characterized by fever and vesicular skin rash. Pneumonia and hepatitis may occur during more severe infections. Examination of acutely infected tissues reveals histopathology including necrosis and hemorrhage in the skin, lung, liver, and spleen. In contrast, the neural ganglia exhibit minimal histopathology. SVV DNA, immediate early, early, and late gene transcripts, and viral antigens are detected in the tissues of acutely infected monkeys. Host immune responses are induced which resolve the acute infection within 21 days. During or after acute infection, SVV establishes latent infection in the ganglia of surviving monkeys. The virus may reactivate later in life to cause secondary disease and viral transmission to susceptible monkeys. J. Med. Virol. 70:S4,S8, 2003. © 2003 Wiley-Liss, Inc. [source] Epidemiology of varicella-zoster virus in England and WalesJOURNAL OF MEDICAL VIROLOGY, Issue S1 2003M. Brisson Abstract Many countries are studying currently the possibility of mass vaccination against varicella. The objective of this study was to provide a complete picture of the pre-vaccine epidemiology of the Varicella-Zoster Virus in England and Wales to aid in the design of immunisation programs. Population-based data including general practitioner sentinel surveillance, hospitalisation data, and death certificates from England and Wales were analysed. The average incidence rates for varicella and zoster between 1991 and 2000 were 1,291 and 373 per 100,000 years, respectively. Overall hospitalisation rates were equal for varicella and zoster (4.5 vs. 4.4 hospitalisation per 100,000 population) with 5 and 8%, respectively, having underlying immunosuppressive conditions. The age-specific proportion of cases hospitalised and length of stay were similar between the two diseases. However, the overall burden of disease is considerably higher for zoster. The number of inpatient days and case-fatality due to zoster are roughly 4 to 6 times greater than for varicella (11 vs. 3 days and 25 vs. 4 deaths per 100,000 case). These results provide base-line estimates should mass varicella vaccination be introduced in England and Wales. J. Med. Virol. 70:S9,S14, 2003. © 2003 Wiley-Liss, Inc. [source] Varicella-zoster virus isolates, but not the vaccine strain OKA, induce sensitivity to alpha-1 and beta-1 adrenergic stimulation of sensory neurones in cultureJOURNAL OF MEDICAL VIROLOGY, Issue S1 2003Michaela Schmidt Abstract The reactivation of varicella-zoster virus (VZV) from its persistent state in sensory neurones causes shingles and induces severe, long-lasting pain and hyperalgesia that often lead to postherpetic neuralgia. To investigate the VZV-induced neuropathic changes, we established conditions for the active infection of sensory neurones from rat dorsal root ganglia in vitro. After 2 days of culture, up to 50% of the cells expressed viral antigens of the immediate-early and late replication phase. The intracellular calcium ion concentration was monitored in individual cells by microfluorimetry. Whereas the calcium response to capsaicin was preserved, the VZV-infected neurones gained an unusual sensitivity to noradrenaline stimulation in contrast to non-infected cells. The adrenergic agonists phenylephrine and isoproterenol had a similar efficacy demonstrating that both ,1 - and ,1 -adrenoreceptors were involved. The sensitivity to adrenergic stimulation was observed after infection with different wildtype isolates, but not with the attenuated vaccine strain OKA. The lack of noradrenaline sensitivity of vaccine-infected neurones demands a structural comparison of wildtype and vaccine viruses with and without phenotype. A partial sequence evaluation (26 kb) of the European OKA vaccine strain surprisingly revealed a series of nucleotide exchanges in comparison to presumably identical OKA strains from other sources, although VZV is generally considered genetically stable. In summary, we report that the infection with wildtype VZV isolates, but not with the vaccine strain, induces noradrenaline sensitivity in sensory neurones, which correlates with clinical and experimental observations of adrenergic effects involved in VZV-induced neuralgia. J. Med. Virol. 70:S82,S89, 2003. © 2003 Wiley-Liss, Inc. [source] Herpes zoster in older adults. (Duke University Medical Center, Durham, NC) Clinical Infectious Diseases.PAIN PRACTICE, Issue 4 20011486., 2001;32:148 Herpes zoster (HZ) strikes millions of older adults annually worldwide and disables a substantial number of them via postherpetic neuralgia (PHN). Key aged-related clinical, epidemiological, and treatment features of zoster and PHN are reviewed in this article. HZ is caused by renewed replication and spread of the varicella-zoster virus (VZV) in sensory ganglia and afferent peripheral nerves in the setting of age-related, disease-related, and drug-related decline in cellular immunity to VZV. VZV-induced neuronal destruction and inflammation causes the principal problems of pain, interference with activities in daily living, and reduced quality of life in elderly patients. Recently, attempts to reduce or eliminate HZ pain have been bolstered by the findings of clinical trials that antiviral agents and corticosteroids are effective treatment for HZ and that tricyclic antidepressants, topical lidocaine, gabapentin, and opiates are effective treatment for PHN. Although these advances have helped, PHN remains a difficult condition to prevent and treat in many elderly patients. Comment by Miles Day, M.D. This article reviews the epidemiology clinical features diagnosis and treatment of acute herpes zoster. It also describes the treatment of postherpetic neuralgia. While this is a good review for the primary care physician, the discussion for the treatment for both acute herpes zoster and postherpetic neuralgia do not mention invasive therapy. It is well documented in pain literature that sympathetic blocks with local anesthetic and steroid as well as subcutaneous infiltration of active zoster lesions not only facilitate the healing of acute herpes zoster but also prevents or helps decrease the incidence of postherpetic neuralgia. All patients who present to the primary care physician with acute herpes zoster should have an immediate referral to a pain management physician for invasive therapy. The treatment of postherpetic neuralgia is a challenging experience both for the patient and the physician. While the treatments that have been discussed in this article are important, other treatments are also available. Regional nerve blocks including intercostal nerve blocks, root sleeve injections, and sympathetic blocks have been used in the past to treat postherpetic neuralgia. If these blocks are helpful, one can proceed with doing crynourlysis of the affected nerves or also radio-frequency lesioning. Spinal cord stimulation has also been used for those patients who are refractory to noninvasive and invasive therapy. While intrathecal methylprednisolone was shown to be effective in the study quoted in this article one must be cautious not to do multiple intrathecal steroid injections in these patients. Multilple intrathecal steroid injections can lead to archnoiditis secondary to the accumulation of the steroid on the nerve roots and in turn causing worsening pain. [source] Safety and Immunogenicity of Varicella-Zoster Virus Vaccine in Pediatric Liver and Intestine Transplant RecipientsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 3 2006A. Weinberg Primary varicella-zoster virus (VZV) infections following organ transplantation may cause significant morbidity. We examined the safety and immunogenicity of Varivax® after transplantation as a potential prophylactic tool. Pediatric liver and intestine transplant recipients without history of chickenpox received one dose of Varivax®. VZV humoral and cellular immunity were assessed before and ,12 weeks after vaccination. Adverse events (AE) and management of exposure to wild type VZV were monitored. Sixteen VZV-naïve subjects, 13,76 months of age, at 257,2045 days after transplantation were immunized. Five children developed mild local AE of short duration. Four subjects developed fever and four developed non-injection site rashes, three of whom received acyclovir. Liver enzymes did not increase during the month after vaccination. Eighty-seven percent and 86% of children developed humoral and cellular immunity, respectively. There were five reported exposures to varicella in four children, none of which resulted in chickenpox. One subject received VZV-immunoglobulin and another subject with liver enzyme elevations after exposure received acyclovir; all remained asymptomatic. Varivax® was safe and immunogenic in pediatric liver and intestine transplant recipients. Larger studies are needed to establish the efficacy and role of varicella vaccination after transplantation. [source] A Two Year Follow-Up Study of Common Virus Infections in Hemodialysis Patients in TaiwanARTIFICIAL ORGANS, Issue 10 2002Tze Wah Kao Abstract: The study was designed to determine whether hemodialysis patients in Taiwan had a different antibody response to common virus infections compared to the normal population. Serum samples from 18 hemodialysis patients and 21 healthy volunteers were obtained every 3 months for 2 years. Geometric mean titers (GMTs) of immunoglobulin G (IgG) antibodies to cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), as well as Type A and Type B influenza viruses (Inf. A, Inf. B) were compared between the patient and the control groups. The prevalence rates and the rates of recurrent infection were similar in both groups. However, the patient group had a higher percentage of persons having persistent EBV and CMV infections (p < 0.05) and also higher GMTs of antibodies nearly the whole year round, especially significant in September and December (p < 0.05). In patients with hepatitis C, their GMTs of EBV, VZV, Inf. A, and Inf. B were higher than those without (p < 0.05). [source] 1212: Herpes simplex and zoster keratitisACTA OPHTHALMOLOGICA, Issue 2010M LABETOULLE Herpes simplex virus (HSV) and varicella-zoster virus (VZV) are two leading causes of corneal infection with potential severely impaired visual acuity. These two viruses share multiple characteristics, including the ability to become latent in the trigeminal ganglia, before reactivation and migration along the trigeminal fibers innervating the cornea. The clinical settings of keratitis may vary from an epithelial defect (dendritic of geographic) to a more severe disease involving the stroma and/or the endothelium. Classically, HSV keratitis occurs from the second decade of life, and associated skin disease is not frequent and only involves the eyelids. In contrast, VZV keratitis mostly occurs after the sixth decade, as an associated finding of herpes zoster ophthalmicus (HZO). However, several studies recently highlighted that the rate of HSV keratitis increases with age, even in elderly, and some other studies reported VZV keratitis in children, either isolated or associated with HZO. Antiviral drugs currently available are highly efficient to reduce the severity on ongoing HSV- or VZV keratitis, but preventive treatments still have to be optimized. For HSV keratitis, the usual preventive treatment, as defined by the HEDS study, only reduces the rate of relapses in a two-fold manner, and the optimal dosage has not been settled for patient with severe herpetic disease. For VZV, the two vaccines against chickenpox and HZO probably will lead in the future to a reduction of the incidence of keratitis, but they are not widely used, even in most of developed countries. [source] | ||||||||||