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Stephen K. Tyring - One of the best experts on this subject based on the ideXlab platform.
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family history as a risk factor for Herpes zoster a case control study
Archives of Dermatology, 2008Co-Authors: Lindsey D Hicks, Robert H Cooknorris, Natalia Mendoza, Vandana Madkan, Anita Arora, Stephen K. TyringAbstract:Objective To assess risk factors for Herpes zoster beyond age and immunosuppression, especially the association with a family history of Herpes zoster, since a preventative Herpes zoster and postherpetic neuralgia vaccine is now available. Design We undertook a case-control study of Herpes zoster, which represents reactivation of latent varicella zoster virus residing in dorsal root ganglia following primary infection, involving 504 patients and 523 controls. Interviews were conducted by trained medical investigators using a structured questionnaire. Setting The Center for Clinical Studies, an outpatient clinic and research center in Houston, Texas. Participants Nonimmunocompromised patients with confirmed cases of Herpes zoster were included in the study. Controls were nonimmunocompromised clinic patients with new diagnoses of skin diseases other than Herpes zoster. Results Cases were more likely to report blood relatives with a history of zoster (39%) compared with controls (11%; P Conclusions The results suggest an association between Herpes zoster and family history of zoster. Future studies will be needed to investigate this association.
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Valacyclovir for the treatment of genital Herpes
Expert review of anti-infective therapy, 2006Co-Authors: Julie S. Brantley, Lindsey Hicks, Karan Sra, Stephen K. TyringAbstract:Genital Herpes is the most prevalent sexually transmitted infection in the USA. While sometimes mild in severity, it can be a distressing and painful chronic condition. Likewise, Herpes labialis and Herpes zoster can be both physically and psychologically painful. While there is no cure for these conditions, treatment to alleviate symptoms, suppress recurrences and reduce transmission has been drastically improved over the past 20 years with the use of guanine nucleoside antivirals, such as valacyclovir hydrochloride (Valtrex), GlaxoSmithKline) the highly bioavailable prodrug of acyclovir (Zovirax((R)), GlaxoSmithKline), and famciclovir (Famvir, Novartis), a highly bioavailable prodrug of penciclovir (Denavir, Novartis). Clinical trials involving approximately 10,000 patients (including patients from nongenital Herpes studies, such as Herpes zoster) have assessed the safety and efficacy of valacyclovir in the treatment of initial genital Herpes outbreaks, episodic treatment of recurrent episodes and daily suppressive therapy. It was shown that valacyclovir has similar efficacy to acyclovir in the episodic and suppressive treatment of genital Herpes. Valacyclovir is the only antiviral drug approved for a once-daily dose of suppressive therapy for genital Herpes, as well as the only antiviral drug US FDA approved for a 3-day regimen of episodic treatment of recurrent genital Herpes. In addition, valacyclovir is also indicated in the reduction of the sexual transmission of Herpes simplex virus infection and for the treatment of Herpes labialis. In Herpes zoster, valacyclovir is more effective than acyclovir or placebo (and as equally effective as famciclovir) in shortening the length and severity of Herpes zoster-associated pain and postherpetic neuralgia. Valacyclovir has an acceptable safety profile in patients with Herpes simplex and Herpes zoster. The less frequent dosing regimen makes it an attractive option in the treatment of genital Herpes and other viral infections, and may contribute to increased patient adherence to therapy.
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Valacyclovir in the treatment of Herpes simplex, Herpes zoster, and other viral infections.
Journal of cutaneous medicine and surgery, 2003Co-Authors: Mathijs H Brentjens, Gisela Torres, Kimberly Yeung–yue, Patricia C. Lee, Stephen K. TyringAbstract:Background: Genital Herpes and Herpes labialis are prevalent, physically and pychologically painful, and often disabling. Herpes zoster is often very painful and may result in months or years of postherpetic neuralgia (PHN). Over the past two decades, the treatment of these conditions has been transformed by guanosine nucleoside antivirals such as valacyclovir (Valtrex®), a highly bioavailable prodrug of acyclovir (Zovirax®), and famciclovir (Famvir®), a highly bioavailable prodrug of penciclovir (Denavir®). Objective: We describe the pharmacology, pharmacokinetics, and clinical efficacy of valacyclovir for the treatment of Herpes simplex, Herpes zoster, and other viral infections. Valacyclovir is also compared with acyclovir and famciclovir. Methods: All published literature containing the word “valacyclovir” was reviewed and summarized. Results: Valacyclovir is the only oral antiviral agent approved for therapy of Herpes labialis, the only antiviral drug approved for a 3-day course in the episodic treatment of recurrent genital Herpes, as well as the only antiviral drug approved for once daily dosing for suppressive therapy. In Herpes zoster, valacyclovir is more effective than acyclovir and equally effective as famciclovir at hastening the healing of zoster-associated pain and PHN. Conclusion: Valacyclovir is safe and effective in the therapy of patients with Herpes simplex and Herpes zoster and may be useful in other viral infections.
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Herpes: Atypical Clinical Manifestations
Dermatologic clinics, 1998Co-Authors: Stephen K. Tyring, Soni S. Carlton, Tanya EvansAbstract:Genital Herpes simplex is predominantly caused by Herpes simplex virus (HSV) type 2 in the United States, although HSV-1 is responsible for 30% of cases of first-episode genital Herpes. Because genital Herpes associated with HSV-2 is much more likely to recur than is genital Herpes caused by HSV-1, more than 90% of recurrent genital Herpes is caused by HSV-2. HSV-2 typically presents as erythematous papules that progress to vesicles that ulcerate, leaving fairly tender lesions. The primary infection tends to cause the most severe symptoms, and recurrences are less painful and of a shorter duration than the primary infection.
Zane A. Brown - One of the best experts on this subject based on the ideXlab platform.
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Prevention of neonatal Herpes
BJOG : an international journal of obstetrics and gynaecology, 2010Co-Authors: C Gardella, Zane A. BrownAbstract:Neonatal Herpes can occur when the neonate is exposed to Herpes simplex virus in the maternal genital tract during labour. Attack rates are highest when the mother has a newly acquired infection and, therefore, does not have antibodies to protect the neonate. Even with early therapy, there is significant morbidity and mortality associated with neonatal Herpes, suggesting that preventing neonatal Herpes simplex virus exposure or early recognition of exposure is important. The incidence of neonatal Herpes has not declined despite national guidelines for prevention. This suggests that the prevention guidelines need to be re-addressed.
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Managing genital Herpes infections in pregnancy.
Cleveland Clinic journal of medicine, 2007Co-Authors: Carolyn Gardella, Zane A. BrownAbstract:Genital Herpes is common and is becoming more so, with a seroprevalence of 25% in middle class primary care settings. Primary genital Herpes in pregnancy most often is subclinical, but it also can cause severe illness. Further, active genital Herpes at the time of vaginal delivery poses significant risk of neonatal infection, especially if the mother acquired the infection in the third trimester. It is important to prevent genital Herpes acquisition in pregnancy and to diagnose recurrent genital Herpes to prevent neonatal Herpes.
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Common use of inaccurate antibody assays to identify infection status with Herpes simplex virus type 2.
American Journal of Obstetrics and Gynecology, 2005Co-Authors: Rhoda Ashley Morrow, Zane A. BrownAbstract:In recent proficiency testing of Herpes simplex virus type–specific serologic evidence by the College of American Pathologists, commercially available Herpes simplex virus antibody assays that were not glycoprotein-G based demonstrated high false-positive rates (14%-88%) for Herpes simplex virus type-2 antibodies in sera that were positive for Herpes simplex virus type-1 antibodies but negative for Herpes simplex virus type-2 antibodies. Herpes simplex virus serologic testing should be performed with only glycoprotein-G–based tests.
Yaoshen Chen - One of the best experts on this subject based on the ideXlab platform.
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orbital apex syndrome an unusual complication of Herpes zoster ophthalmicus
BMC Infectious Diseases, 2015Co-Authors: Hungchin Tsai, Yaoshen ChenAbstract:Herpes zoster ophthalmicus is defined as Herpes zoster involvement of the ophthalmic division of the trigeminal nerve. Ocular involvement occurs in 20–70% of patients with Herpes zoster ophthalmicus and may include blepharitis, keratoconjunctivitis, iritis, scleritis, and acute retinal necrosis. Orbital apex syndrome is a rare but severe ocular complication of Herpes zoster ophthalmicus. We present here the first reported case of Herpes zoster ophthalmicus complicated by orbital apex syndrome in a patient from Taiwan.
Robert H. Dworkin - One of the best experts on this subject based on the ideXlab platform.
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natural history and treatment of Herpes zoster
The Journal of Pain, 2008Co-Authors: Kenneth E Schmader, Robert H. DworkinAbstract:Abstract The objective of this article is to provide an overview of the natural history and treatment of Herpes zoster, with a focus on pain management. Herpes zoster has the highest incidence of all neurological diseases, occurring annually in approximately 1 million people in the United States. A basic feature of Herpes zoster is a marked increase in incidence with aging and with diseases and drugs that impair cellular immunity. Herpes zoster begins with reactivation of varicella zoster virus in dorsal root or cranial nerve ganglia, which is often accompanied by a prodrome of dermatomal pain or abnormal sensations. Varicella zoster virus spreads in the affected primary afferent nerve to the skin and produces a characteristic dermatomal maculopapular and vesicular rash and pain. Herpes zoster acute pain lowers quality of life and interferes with activities of daily living. Antiviral therapy and scheduled analgesics form the pharmacotherapeutic foundation for Herpes zoster acute pain reduction. If moderate to severe Herpes zoster pain is not adequately relieved by antiviral agents in combination with oral analgesic medications, then corticosteroids, anticonvulsants (eg, gabapentin or pregabalin), tricyclic antidepressants (eg, nortriptyline or desipramine), or neural blockade can be considered. Perspective This article presents information on the clinical features and treatment of Herpes zoster. This information will help clinicians diagnose and manage Herpes zoster pain.
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The role of sympathetic nerve blocks in Herpes zoster and postherpetic neuralgia.
Pain, 2000Co-Authors: Christopher L Wu, Ann Marsh, Robert H. DworkinAbstract:The most common complication of Herpes zoster in immunocompetent patients is postherpetic neuralgia (PHN). Sympathetic blocks have been traditionally used for patients with Herpes zoster and PHN with three different therapeutic goals: pain relief during acute Herpes zoster, pain relief during PHN, and prevention of PHN by treating patients with acute zoster. The role of sympathetic blocks in Herpes zoster and PHN remains controversial due to methodologic shortcomings in published studies and the limited current understanding of the role of the sympathetic nervous system in mediating pain. Current theories of the pathophysiology of PHN, the role of the sympathetic nervous system in Herpes zoster and PHN, and published studies investigating use of sympathetic nerve blocks in Herpes zoster and PHN are reviewed.
David A. Baker - One of the best experts on this subject based on the ideXlab platform.
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Herpes simplex virus infections.
Current opinion in obstetrics & gynecology, 1992Co-Authors: David A. BakerAbstract:Abstract This review discusses current reports on Herpes simplex virus infections as they relate to the use of laboratory testing, infections in the neonate, Herpes simplex virus association with human immunodeficiency virus infection, and updating the current therapy and management of genital Herpes. Findings over the past year are important in the clinical management of patients with genital Herpes. All health care workers who manage patients with genital Herpes need to know the limitations of serologic testing. Current information suggests that serologic commercial testing that is most commonly available cannot discriminate between infections caused by Herpes simplex virus type 1 and type 2. Laboratory methods still rely on culturing Herpes simplex virus in living cells in vitro. However, the availability of monoclonal antibodies allows for rapid assays for the confirmation of cultured Herpes simplex virus. In addition, assays have been developed and tested, suggesting that perhaps antigen-detection systems may be available that could replace culturing the virus in living cells. New information on neonatal Herpes points out the predictors of morbidity and mortality in newborns who contract Herpes within the first few weeks of life. Information concerning asymptomatic shedding in labor will provide the clinician with a better understanding of this disease entity in the pregnant woman. Several studies have confirmed that Herpes simplex virus infection is a risk factor for developing human immunodeficiency virus infection. A new study clearly shows that treatment using daily acyclovir therapy over a prolonged period of time can control and may modify Herpesvirus infection.
