Catarata congênita nas infecções intrauterinas mais comuns (STORCH): revisão de literatura / Congenital cataract in the most common intrauterine infections (STORCH): a review of the literature

RESUMO Objetivo: O objetivo deste estudo foi revisar os aspectos clínicos e patológicos da catarata congênita secundária às infecções por sífilis, toxoplasmose, rubéola, citomegalovírus e herpes simples. Métodos: Trata-se de uma revisão de literatura, na qual foram incluídos artigos de periódicos indexados às bases de dados PubMed®, Cochrane, Lilacs, Embase e SciELO de 2010 a 2023. Resultados: Foram encontrados 45 artigos, e, após seleção, restaram 9 artigos. Além disso, foram adicionados artigos para enriquecer a discussão. A infecção por sífilis está relacionada a alterações corneanas. O citomegalovírus e a toxoplasmose estão relacionados com a coriorretinite e/ou microftalmia. A rubéola é responsável por causar catarata, glaucoma, microftalmia e retinite em sal e pimenta. Conclusão: Foram abordadas as principais etiologias infecciosas e seu quadro clínico na CC. O melhor tratamento para CC é cirúrgico associado a acompanhamento clínico, mas a prevenção é a maneira mais eficaz de combater a CC de etiologia infecciosa. O diagnóstico precoce e o tratamento efetivo previnem alterações e sequelas visuais irreversíveis. Nesse contexto, mostram-se importantes as ações de políticas públicas para o melhor desfecho clínico e melhor qualidade de vida.

ABSTRACT Objective: To review the clinical and pathological aspects of CC secondary to infections by syphilis, toxoplasmosis, rubella, cytomegalovirus, herpes simplex. Methods: This is a literature review. Articles from journals indexed to PubMed, COCHRANE, LILACS, EMBASE and SCIELO from 2010 to 2023 were included. Results: A total of 45 articles were found, which, after selection, remained in 9 articles. Some articles were included to enrich the discussion in this topic. The infection caused by syphilis is related to corneal changes. Cytomegalovirus and Toxoplasmosis due to chorioretinitis and/or microphthalmia. Rubella is responsible for causing cataracts, glaucoma, microphthalmia, and salt and pepper retinitis. Conclusion: The main infectious etiologies and their clinical status in CC were addressed. The best treatment for CC is surgery associated with clinical follow-up, but prevention is the most effective way to combat CC of infectious etiology. Early diagnosis and effective treatment prevent irreversible visual changes and sequelae. In this context, public policy actions are important for the best clinical outcome and better quality of life.

Vacunación contra el herpes zóster en Argentina / Vaccination against herpes zoster in Argentina

Durante los últimos meses, quienes trabajamos en Argentina en el ámbito de la atención primaria como médicos de cabecera hemos recibido muchas consultas de pacientes solicitando nuestra opinión sobre una vacuna que no está actualmente incluida en el Calendario Nacional de Vacunación y que además estaba fuera de nuestra agenda: la vacuna contra el herpes zóster. Este artículo editorial pretende ayudar a los equipos de salud a realizar con sus pacientes un proceso de toma de decisiones compartidas en las consultas acerca de esta nueva vacuna. (AU)

During the last few months, those of us who work in Argentina in the field of primary care as general practitioners have received many inquiries from patients requesting our opinion about a vaccine that is not currently included in the National Vaccination Schedule and that, in addition, was off our scope: the herpes zoster vaccine. This editorial article aims to help our health teams carry out a shared decision-making process with their patients regarding this new vaccine. (AU)

A study on knowledge, attitude, and vaccination behavior of herpes zoster vaccine among urban residents in selected areas of China / 中华流行病学杂志

Objective: To understand the knowledge, attitude, and current status of vaccination of herpes zoster vaccination among urban residents aged 25 years and above in China. Methods: In August to October 2022, a convenience sampling method was used to survey residents aged 25 years and above at 36 community centers in 9 cities across China. Questionnaires were used to collect basic information, knowledge, and attitude toward herpes zoster and its vaccination, as well as vaccination status and reasons for non-vaccination among residents. Results: A total of 2 864 urban residents were included in the study. The total score of residents' cognition of herpes zoster and its vaccine was 3.01±2.08, and the total score of their attitude was 18.25±2.76. Factors such as being male (β=-0.45, P<0.001), older than 40-59 years (β=-0.34, P=0.023) or ≥60 years (β=-0.68, P<0.001), married (β=-0.69, P=0.002) were negatively associated with knowledge score. The educational level of high school or secondary school (β=0.44, P=0.036), college (β=0.65, P=0.006), bachelor's degree and above (β=1.20, P<0.001), annual net household income ≥120 000 Yuan in 2021 (β=0.42, P=0.020), having urban employee medical insurance (β=0.62, P=0.030), having public or commercial medical insurance (β=0.65, P=0.033), and having a history of chickenpox (β=0.29, P=0.025) were positively associated with knowledge scores. Being male (β=-0.38, P=0.008) and not remembering a history of chickenpox (β=-0.49, P=0.012) were negatively associated with attitude scores. Annual net household income in 2021 was between 40 000-80 000 Yuan (β=0.44, P=0.032) or between 80 000-120 000 Yuan (β=0.62, P=0.002) or ≥120 000 Yuan (β=0.93, P<0.001), and a history of herpes zoster (β=0.59, P=0.004) were positively associated with attitude scores. Of the 2 864 residents surveyed, only 29 (1.01%) had received the herpes zoster vaccine, with a vaccination rate of 1.70% for those aged 50 years and above, with the main reason for non-vaccination being lack of knowledge about the herpes zoster vaccine, followed by the high price. 42.67% of the population said they would consider getting the herpes zoster vaccine in the future. Conclusion: Low knowledge of herpes zoster and its vaccine, positive attitudes towards the preventive effects of herpes zoster and its vaccine, and extremely low vaccination rates among the urban population in China call for multiple measures to strengthen health education and vaccination recommendations for residents, especially for the elderly, low-education and low-income populations.

Genetic characterization of varicella-zoster virus in people aged 20 years and under in Yichang City of Hubei Province, 2019-2020 / 中华流行病学杂志

Objective: To analyze the genetic characteristics of varicella-zoster virus (VZV) in people aged 20 years and under in Yichang City of Hubei Province from 2019 to 2020. Methods: Based on the Yichang Health Big Data Platform, we investigated cases 20 and under clinically diagnosed as herpes zoster in three hospitals from March 2019 to September 2020. Collecting vesicle fluid and throat swab samples of the cases and completing questionnaires to obtain basic information. Real-time fluorescent quantitative PCR was used for positive identification of the virus. PCR amplification of VZV's open reading frame (ORF) and sequencing of the products to determine the VZV genotype. Analyze mutations at some specific single nucleotide polymorphism (SNP) sites. Results: Among 46 cases of herpes zoster, the male to female ratio was 1.3∶1 (26∶20) and the age ranged from 7 to 20 years old. Fifteen cases had been vaccinated against varicella, including 13 and 2 cases of 1 and 2 doses, respectively. VZV strains were detected in 34 samples (73.91%), all belonging to Clade 2. Phylogenetic tree analysis of the nucleotide of ORF22 showed, compared with Clade 2 referenced strains, the sequence matching degree of nucleotide for all 34 samples was 99.0% to 100.0%. Conclusion: The main VZV strain causing herpes zoster in people aged 20 years and under in Yichang from 2019 to 2020 was Clade 2.

Effect of the varicella vaccination on the clinical characteristics of herpes zoster cases aged 20 years and under / 中华预防医学杂志

To discuss the effect of varicella vaccination on the clinical characteristics of herpes zoster (shingles) cases aged 20 years and under, and analyze its clinical features. Based on the Yichang Health Big Data Platform, a descriptive study was conducted to collect the information of cases aged 20 years and under in three medical institutions of Yichang Central People's Hospital, Yichang First People's Hospital and Yichang Second People's Hospital from March 2019 to September 2020. According to the history of varicella vaccine, cases were divided into vaccination group and non-vaccination group, and their clinical features and outcomes were compared. The results showed that 46 shingles cases, aged from 7 to 20 years old, were included in this study. 26 males (56.5%), 20 females (43.5%), 15 cases in vaccination group (32.6%) and 31 cases in non-vaccination group (67.4%). 28 cases had thoracic involvement, followed by lumbar (n=8), cranial (n=7) involvements and extremities (n=7). The spread of herpes skin area: 2 cases involved too large area, 21 cases of 10 cm×10 cm, 14 cases of 5 cm×5 cm, 9 cases of 1 cm×1 cm. Herpes number: 26 cases had 10-49 herpes, followed by <10 herpes (n=9), uncountable herpes (n=7) and 50-99 herpes (n=4). The clinical course[M(Q1,Q3)] lasted 20.5 (13.5,24.8) d averagely, 5 cases had postherpetic neuralgia (PHN) and 1 case had respiratory complications. Shingles decrustation time was significantly shorter in vaccination group (Z=-2.01, P<0.05), and there was no significant difference in other characteristics by vaccination. In conclusion, the number and spread of shingles in most children and adolescents are less, and the complications such as PHN are less. Varicella vaccination can reduce the decrustation time and relieve shingles cases with some clinical symptoms.

Genomic structure of varicella-zoster virus and its vaccine application status / 中华预防医学杂志

With the determination of the whole genome sequence of varicella-zoster virus (VZV) virus, the successful breakthrough of infectious cloning technology of VZV, and the emergence of effective preventive vaccines, which have been proven to be effective and safe, varicella has become a disease preventable by specific immunity. This article will review the genomic structure, epidemiological characteristics, and research application progress of varicella vaccine and herpes zoster vaccine of varicella zoster virus to provide reference for primary prevention of the disease.

Research progress on drug resistance of anti-varicella-zoster virus drugs / 中华预防医学杂志

Varicella-zoster virus (VZV) causes chickenpox when it first infects humans, and the virus may reactivate in adulthood and cause herpes zoster (HZ). Broad-spectrum antiviral drugs are one of the treatments for varicella and herpes zoster, but the emergence of drug resistance poses many challenges to this treatment and increases the burden of disease on patients. This paper discusses the resistance mechanisms, resistance sites and resistance detection methods of anti-VZV drugs in order to help further research on new anti-VZV targets, new drugs and monitoring of resistance to existing drugs.

Complications of herpes zoster hospitalizations in a reference hospital in Fortaleza-Ceará, 2009-2018 / Complicações de internações por herpes zoster em um hospital de referência em Fortaleza-Ceará, 2009-2018

Objective: the aim of this study was to relate sociodemographic, epidemiological and clinical conditions to the occurrence of severe cases of HZ in reference hospital of Fortaleza. Methods: this is a cross-sectional analytical study, based on medical records of patients admitted from 2009 to 2018. Pearson's x2 test or Fisher's exact test were used when appropriate. Results: we analyzed 196 medical records. The presence of complications occurred in 69.9%, the most affected region was the cranial (68.9%), and 1.5% died. The presence of vesicles (PR=1.37; 95%CI: 1.03-1.82; p=0.01) and the choice of antibiotic associated antiviral therapy (PR=0.58; 95%CI: 0.46-0.73; p=0.00) were significantly associated with the severity. Conclusions: the disease may be more severe at ages over 50. The presence of lesions in vesicles was associated with a higher prevalence of complications and the use of antibiotics and antivirals as a protective factor.

Objetivo: relacionar condições sociodemográficas, epidemiológicas e clínicas à ocorrência de casos graves de HZ em hospital de referência de Fortaleza. Métodos: trata-se de um estudo analítico transversal, baseado em prontuários de pacientes internados de 2009 a 2018. Foram utilizados o teste x2 de Pearson ou o teste exato de Fisher, quando apropriado. Resultados: foram analisados 196 prontuários. A presença de complicações ocorreu em 69,9%, a região mais acometida foi a craniana (68,9%), e 1,5% foi a óbito. A presença de vesículas (RP=1,37; IC95%: 1,03-1,82; p=0,01) e a escolha da terapia antiviral associada a antibióticos (RP=0,58; IC95%: 0,46-0,73; p=0,00) foram significativamente associadas com a gravidade. Conclusões: a doença pode ser mais grave a partir dos 50 anos. A presença de lesões em vesículas foi associada à maior prevalência de complicações e o uso de antibióticos e antivirais como fator de proteção.

Efectividad del láser de baja potencia como terapia adyuvante en pacientes con herpes zóster / Effectiveness of the low power laser as adjuvant therapy in patients with zoster herpes

Introducción: El láser de baja potencia tiene un amplio uso en la práctica médica actual. Existe un gran número de pacientes con afecciones agudas o crónicas que pueden ser tratados con esta terapia, con resultados alentadores, muy superiores a los obtenidos con el uso de la terapéutica convencional. Objetivo: Evaluar la efectividad del láser de baja potencia como terapia adyuvante para reducir el tiempo de respuesta al alivio del dolor en pacientes con herpes zóster. Métodos: Se realizó un estudio cuasiexperimental, de intervención terapéutica, en 21 pacientes con herpes zóster, atendidos en el Servicio de Fisiatría del Policlínico del MININT de Santiago de Cuba, desde enero de 2016 hasta junio de 2017. Se conformaron 2 grupos de forma aleatoria: los integrantes del primero recibieron el tratamiento habitual con aciclovir, vitaminas y analgésico (control); los del segundo, aciclovir, vitaminas y laserterapia (intervención). Resultados: Se observó que en el grupo de intervención la intensidad del dolor fue disminuyendo en relación con la evaluación inicial. Así, en la quinta sesión se apreció mayor porcentaje de pacientes con alivio del dolor que en el grupo control, al igual que en la décima sesión y 21 días después, de ahí la efectividad del tratamiento. Conclusiones: Con el empleo del láser de baja potencia los pacientes con herpes zóster presentaron una mejoría del dolor en menor tiempo, con una respuesta satisfactoria expresada en la totalidad de ellos, por lo que se recomienda su utilización como terapia adyuvante.

Introduction: The low power laser has a wide use in the current medical practice. There is a great number of patients with acute or chronic conditions that can be treated with this therapy, with encouraging results, far better than those obtained with the use of conventional therapy. Objective: To evaluate the effectiveness of low power laser as adjuvant therapy to reduce the response time to pain relief in patients with zoster herpes. Methods: A quasi-experiment study of therapeutic intervention was carried out in 21 patients with zoster herpes. They were assisted in the Physical Medicine Service of the MININT Polyclinic in Santiago de Cuba, from January, 2016 to June, 2017. Two groups were conformed at random: the members of the first one received acyclovir, vitamins and lasertherapy (intervention); those of the second group received acyclovir, vitamins and analgesic (control). Results: It was observed that in the intervention group the intensity of the pain was diminishing in connection with the initial evaluation. This way, in the fifth session it was appreciated a higher percentage of patients with pain relief that in the control group, the same as in the tenth session and 21 days later, hence the effectiveness of the treatment. Conclusions: With the use of low power laser the patients with zoster herpes presented an improvement of the pain in less time, with a satisfactory response expressed in all of them, reason why its use is recommended as adjuvant therapy.

The association of family history of herpes zoster and the risk of incident herpes zoster: the SHEZ Study

BACKGROUND@#We investigated whether family histories of herpes zoster (HZ) are associated with the risk of incident HZ in a Japanese population.@*METHODS@#A total of 12,522 Japanese residents aged ≥50 years in Shozu County participated in the baseline survey between December 2008 and November 2009 (the participation rate = 72.3%). They were interviewed at baseline by research physicians regarding the registrants' history of HZ. A self-administered questionnaire survey was conducted to evaluate the potential confounding factors. 10,530 participants without a history of HZ were followed up to ascertain the incidence of HZ during 3-years follow-up until the end of November 2012 with Japanese nationals. We estimated hazard ratios (HRs) of incident HZ according to first-degree family histories using the Cox proportional hazard regression after adjusting for age, sex, and other potential confounding factors.@*RESULTS@#Compared to no HZ history of each family member, a history of brother or sister was associated with a higher risk of incident HZ while histories of father and mother were not. The multivariable HR (95%CI) of incident HZ for a history of brother or sister was 1.67 (1.04-2.69). When comparing to no family histories of all first-degree relatives, the multivariable HRs (95%CIs) were 1.34 (0.77-2.34) for a history of brother or sister alone, but 4.81 (1.78-13.00) for a history of mother plus brother or sister. As for the number of family histories, the multivariable HRs (95%CIs) were 1.08 (0.76-1.54) for one relative (father, mother, or brother or sister) and 2.75 (1.13-6.70) for two or more relatives.@*CONCLUSION@#Family histories of mother plus brother or sister and two or more first-degree relatives were associated with a higher risk of incident HZ.

Study on Herpes Zoster Reactivation Induced by Arsenic in Patients with Acute Promyelocytic Leukemia / 中国实验血液学杂志

OBJECTIVE@#To investigate herpes zoster reactivation induced by arsenic in patients with acute promyelocytic leukemia (APL).@*METHODS@#The clinical data of 212 patients with APL treated in the Department of Hematology of the First Affiliated Hospital of Xi'an Jiaotong University from 2008 to 2019 were retrospectively analyzed to observe the activation of varicella zoster virus induced by arsenic. Kaplan-Meier analysis, chi-square test, and boxplot were used to analyze and describe the cumulative dose of arsenic and the time from the beginning of arsenic treatment to the occurrence of herpes zoster.@*RESULTS@#Excluding early death cases and early automatic discharge cases, 17 cases developed herpes zoster reactivation in 175 patients with APL treated with arsenic, and the cumulative median dose of arsenic was 6.2(2-12) mg/kg. Precise risk of reactivation of herpes zoster with 10 months in APL patients treated by arsenic was 9.7%.@*CONCLUSION@#Arsenic treatment can induce high reactivation rate of herpes zoster virus.

Research progress on the incidence and economic burden of herpes zoster disease in immunocompromised population / 中华预防医学杂志

With the increase of age or the impairment of immune function, the specific cellular immune level against varicella zoster virus (VZV) in the body decreases, and the latent VZV in the ganglion can be reactivated to cause herpes zoster (HZ). HZ and its main complication postherpetic neuralgia (PHN) can seriously affect the quality of life of patients. The immunocompromised (IC) population is more prone to HZ than the immunocompetent population due to diseases and therapeutic drugs. This paper reviews the incidence, risk factor and economic burden of HZ in IC population with special health status, to provide ideas for research and adjustment of immunization strategies in the future.

Analysis on vaccination willingness and related factors of influenza, pneumonia, and herpes zoster vaccine among people over 50 years old in Minhang district of Shanghai / 中华预防医学杂志

Objective: To determine the knowledge of influenza, pneumonia, herpes zoster and related vaccines, willingness to vaccinate under multiple payment scenarios, and corresponding risk factors among people over 50 years old in Minhang District of Shanghai. Methods: A total of 1 672 respondents aged 50-69 from 13 communities/towns in Minhang district of Shanghai were included in this study using a stratified random sampling strategy on December 2020. The knowledge of influenza, pneumonia, herpes zoster and vaccines was investigated using a questionnaire, and the differences in the willingness under multiple payment scenarios were determined using chi-square test. The consistency in the willingness under multiple payment scenarios was compared using Cohen's Kappa and the risk factors of the willingness was determined using ordinal logistic regression. Results: The average age of 1 672 respondents was (60.48±5.96) years old, including 777 (46.47%) males and 895 (53.53%) females. A total of 1 350 subjects (80.74%) had local household registration in Shanghai. The proportion of the willingness to vaccinate for themselves, spouses, and parents under any payment scenario was determined to be 80.6% (influenza vaccine), 81.5% (pneumonia vaccine), and 74.0% (herpes zoster vaccine). The willingness to vaccinate against influenza and pneumonia under multiple payment scenarios remained stable (Kappa value ≥0.6), while that against herpes zoster infection was inconsistent (Kappa value ≤0.35). Logistic regression analysis showed that respondents who had higher knowledge of influenza and influenza vaccine [OR (95%CI): 1.111 (1.054-1.170), 1.182 (1.126-1.240), respectively], aged 50-59 [1.305 (1.085-1.531)] and local household registration in Shanghai [1.372 (1.079-1.721)] had higher willingness to vaccinate against influenza, while males had lower willingness [0.733 (0.551-0.910)]. Respondents who had higher knowledge of pneumonia and pneumonia vaccine [OR (95%CI): 1.837 (1.152-2.517), 2.217 (1.541-2.893), respectively] had higher willingness to receive pneumonia vaccine. Respondents aged 50-59 [1.327 (1.059-1.537)] and with local household registration in Shanghai [2.497 (1.417-4.400)] were more likely to be vaccinated against herpes zoster, while those with middle school degree or below [0.664 (0.396-0.992)] and high school degree [0.559 (0.324-0.964)] were less likely to be vaccinated. Conclusion: Among people aged over 50 years old in Minhang district of Shanghai, the willingness to vaccinate for themselves, spouses, and parents against influenza, pneumonia and herpes zoster infection is quite different under multiple payment scenarios, especially for herpes zoster vaccine.

Study of incidence and economic burden of herpes zoster based on community investigation among the aged in Laiwu district, Jinan city, Shandong Province of China / 中华预防医学杂志

Objective: To understand the incidence and economic burden of herpes zoster among the aged in Laiwu district, Jinan city. Methods: Retrospective cohort study was conducted in 5 communities in Laiwu District, Jinan City from July to September, 2019. A total of 8 300 residents born before July 1, 1959 and aged ≥60 years old were included in the investigation. At the same time, an economic burden survey was carried out among 220 cases who developed herpes zoster after July 1, 2017. A questionnaire was used to collect information on incidence and economic burden of HZ, and comparisons were carried out about the incidence and economic burden of herpes zoster among older people with different characteristics. Results: The age of 8 300 subjects was (71.46±6.71) years old. Male and female accounted for 44.10% and 55.90%, respectively. The cumulative incidence of disease after the age of 60 was 73.61‰ among population aged ≥60 years old. The cumulative incidence was 28.03‰, 71.26‰, 86.09‰, 93.48‰ and 88.10‰ among population aged 60-64, 65-69, 70-74, 75-79 and ≥80 years old,respectively. The average annual incidence of HZ was 9.49‰ and annual incidence was 7.59‰, 7.23‰, 8.43‰, 10.24‰ and 13.98‰ in 2014-2018, respectively. HZ cost was (2 626±667) RMB per patient with a median cost of 715 RMB (interquartile range 303-2 358) on 220 cases who developed disease after July 1, 2017. The cost of outpatient cases was (1 329±1 835) RMB per patient with a median cost of 560 RMB (interquartile range 300-1 320), and the cost of inpatient cases was (14 303±16 571) RMB per patient with a median cost of 8 190 RMB (interquartile range 4 368-15 160). Conclusion: The incidence of HZ is high among population aged≥60 years old, which could cause heavy economic burden for them.

A case report of Herpes Zoster of the Trigeminal Ganglion after Coronavirus 2019 vaccination in a 22-year-Old male

Introduction@#Herpes zoster is an acute viral syndrome caused by the reactivation of latent varicella-zoster virus from a previous infection. It is characterized by a painful, unilateral vesicular rash which is distributed over the territory of a dermatome. It is a significant global burden with the incidence very common in the Asia Pacific region. The frequency is closely related with increasing age and is the most common risk factor for reactivation of varicella-zoster virus. Herpes zoster does not often appear after administration of vaccination. But in the advent of increasing vaccinations for COVID-19, there have been reports of herpes zoster following COVID-19 vaccination.@*Case@#This is a case of a 22-year-old healthy male with a previous history of varicella-zoster virus infection during childhood who developed headache, unilateral vesicular rash over the territory of the left trigeminal nerve and left-sided facial pain and numbness. The patient had previously received the COVID-19 vaccine four days prior to the onset of symptoms. The diagnosis of herpes zoster was made on clinical grounds with no need for additional laboratory work-up to confirm the diagnosis. The patient was treated with herpes zoster antiviral therapy and analgesics where improvement of the patient’s condition was noted with eventual crusting of the lesions and without development of complications.@*Conclusion@#Herpes zoster is a common disease with a benign course in immunocompetent adults. There is a need for further studies to identify risk factors and explain the possible relationship between COVID-19 vaccination and the development of herpes zoster. Due to the increasing COVID-19 vaccination of the population worldwide, there is a possibility of an increase in the number of herpes zoster cases following COVID-19 vaccination.

Prognóstico da COVID-19 em pacientes com coinfecção viral: revisão de literatura / COVID-19 prognosis in patients with viral coinfection: literature review

Casos de infecção pelo coronavírus surgiram em 2019 e fatores de risco podem conduzir complicações, entre elas, a coinfecção viral podendo comprometer a resposta imunológica e interferir no prognóstico. Objetivos: Analisar estudos sobre coinfecção viral na COVID-19, avaliando prevalência e correlação com seu prognóstico. Métodos: Foram realizadas buscas em bases de dados utilizando os descritores: SARS-COV 2, coinfecção, vírus, coronavírus, e COVID-19. Resultados: Foram selecionados 12 artigos com os seguintes vírus: influenza, HIV e herpes. Apesar da coinfecção com influenza ser pouco prevalente, seu reconhecimento permitiu compreender diferentes manifestações clínicas e tratamento adequado. Já a coinfecção com HIV revelou que pacientes com AIDS não tratada tiveram pior prognóstico. Por fim, a coinfecção com herpes resultou em reativação, com os seguintes tipos associados: HSV-1, HSV-3, EBV, CMV e HHV-6. Conclusão: Não há evidências científicas suficientes para afirmar que a coinfecção com SARS-COV 2 com outros vírus traz pior prognóstico para COVID-19, sendo necessários mais estudos sobre tais interações

Cases of coronavirus infection emerged in 2019 and risk factors can lead to complications, including viral coinfection, which can compromise the immune response and interfere with prognosis. Objectives: To analyze studies on viral coinfection in COVID-19, evaluating prevalence and correlation with its prognosis. Methods: Database searches were performed using the descriptors: SARS-COV 2, coinfection, virus, coronavirus, and COVID-19. Results: Twelve articles with the following viruses were selected: influenza, HIV and herpes. Although coinfection with influenza is not very prevalent, its recognition made it possible to understand different clinical manifestations and appropriate treatment. Coinfection with HIV revealed that patients with untreated AIDS had a worse prognosis. Finally, coinfection with herpes resulted in reactivation, with the following types associated: HSV-1, HSV-3, EBV, CMV, and HHV-6. Conclusion: There is not enough scientific evidence to state that co-infection with SARS-COV 2 with other viruses brings a worse prognosis for COVID-19, and further studies on such interactions are needed

Relação entre a recorrência do herpes simples e o estresse durante a pandemia de covid-19 em estudantes de odontologia / Relation between the recurrence of herpes simplex and stress during the covid-19 pandemic in dental students

Introdução: A infecção viral causada pelo HSV-1 leva ao aparecimento das lesões do herpes simples e é caracterizada por períodos de infecção primária, latência e recorrência. Durante a vida do indivíduo esta infecção pode ser reativada por diversos fatores como o estresse. No contexto pandêmico de COVID-19, observa-se um aumento de efeitos psicológicos negativos derivados da exaustão emocional entre os estudantes universitários. Objetivo: Avaliar a relação entre o estresse e a recorrência de lesões do herpes simples bucal durante a pandemia de COVID-19 nos estudantes de graduação em odontologia. Materiais e Métodos: Este estudo observacional, descritivo, transversal e de abordagem quali-quantitativo, foi realizado com uma população constituída por 347 estudantes de odontologia, maiores de 18 anos independente de gênero e cor da pele, que já apresentaram episódios primários e/ou recorrentes de herpes simples bucal antes da pandemia de COVID-19. Foram excluídos os estudantes matriculados em odontologia que se recusaram a concordar com o termo de consentimento livre e esclarecido (TCLE). Resultados: A maioria dos participantes era do gênero feminino (81%) com idade entre 20 e 23 anos. Somente 8% apresentaram recorrência das lesões do herpes simples durante o período pandêmico. Entre eles, 78% apresentaram 1 vez, 11% indicaram 4 vezes e 11% revelaram 5 vezes. Analisou-se o nível de estresse, ansiedade e depressão dos participantes por meio da escala DASS-21 e observou-se que entre os colaboradores que apresentaram recorrência do herpes simples bucal, 44% apresentavam ansiedade grave. Ademais, 44% dos participantes manifestaram nível grave e outros 44% nível moderado de estresse. Conclusão: O estudo mostrou o impacto negativo que o período da pandemia de COVID-19 tem causado nos estudantes de odontologia. Notou-se que a parcela da população que apresentou a recorrência das manifestações do vírus em grande maioria indicou ansiedade no nível grave e estresse nos níveis moderado e grave.

Introduction: The viral infection caused by HSV-1 leads to manifestation of herpes simplex lesions and is characterized by periods of primary infection, latency and recurrence. During the individual's life, this infection can be reactivated by several factors such as stress. In the COVID-19 pandemic context, an increase in negative psychological effects derived from emotional exhaustion among university students is observed. Objective: To evaluate the relationship between stress and recurrence of oral herpes simplex lesions during the COVID-19 pandemic in undergraduate dentistry students. Materials and Methods: This observational, descriptive, cross-sectional study, with a quali-quantitative approach, was carried out with a population consisting of 347 dentistry students, over 18 years old, regardless of gender and skin color, who had already had primary episodes and/or recurrent oral herpes simplex before the COVID-19 pandemic. Students enrolled in Dentistry who refused to agree to the free and informed consent form (ICF) were excluded. Results: Most participants were female (81%), aged between 20 and 23 years. Only 8% had recurrence of herpes simplex lesions during the pandemic period. Among them, 78% presented 1 time, 11% indicated 4 times and 11% revealed 5 times. The level of stress, anxiety and depression of the participants was analyzed using the DASS-21 scale and it was observed that among the collaborators who presented recurrence of oral herpes simplex, 44% had severe anxiety. Besides, 44% of participants expressed a severe level and another 44% moderate level of stress. Conclusion: The study showed the negative impact that the period of the COVID-19 pandemic has caused in dentistry students. It was noted that the portion of thepopulation that presented the recurrence of the manifestations of the virus in the vast majority indicated severe level anxiety and stress at moderate and severe levels

O conhecimento dos profissionais de saúde sobre vacinação de pessoas vivendo com HIV - uma revisão integrativa / El conocimiento de los profesionales de la salud sobre la vacunación de personas que viven con VIH - revisión integradora / Health professionals' knowledge about vaccination of people living with HIV - an integrative review

Resumo Objetivo Identificar evidências na literatura acerca do conhecimento dos profissionais de saúde sobre vacinação das pessoas vivendo com HIV. Método Trata-se de uma revisão integrativa. Para a busca, foram utilizados os descritores: pessoal de saúde (health personnel), conhecimento (knowledge), vacinação (vaccination), HIV e seus sinônimos, sem utilização de filtros, nas bases de dados Pubmed, Biblioteca Virtual em Saúde, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Embase, Scopus, Science Direct e Cochrane. Foram incluídos apenas artigos primários analisados por meio do aplicativo RAYYAN. Resultados De 601 publicações iniciais, apenas cinco constituíram a amostra final, todas identificadas no Pubmed publicadas entre 2013 e 2018, sendo nenhum estudo brasileiro. A maioria das publicações estava relacionada a alguma vacina específica e não abordava todo o calendário vacinal. Conclusão e implicações para a prática O déficit de conhecimento dos profissionais de saúde, em relação às vacinas indicadas às pessoas vivendo com HIV, foi o principal aspecto identificado, resultando em insegurança dos profissionais. Há a necessidade de educação permanente das equipes multiprofissionais dos serviços especializados e da atenção primária visando diminuir as barreiras e aumentar a cobertura vacinal desta clientela.

Resumen Objetivo Identificar evidencias en la literatura acerca del conocimiento de los profesionales de la salud sobre la vacunación de personas que viven con VIH. Método Revisión integradora. Para la búsqueda, se utilizaron los descriptores: personal de salud (health personnel), conocimiento (knowledge), vacunación (vaccination), VIH y sus sinónimos, sin el uso de filtros, en las bases de datos Pubmed, Biblioteca Virtual en Salud, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Embase, Scopus, Science Direct y Cochrane. Solo se incluyeron los artículos primarios analizados mediante la aplicación RAYYAN. Resultados De 601 publicaciones iniciales, solo cinco constituyeron la muestra final, todas identificadas en Pubmed y publicadas entre 2013 y 2018, sin ningún estudio brasileño. La mayoría de las publicaciones estaban relacionadas con una vacuna específica y no abordaban todo el calendario de vacunación. Conclusión e implicaciones para la práctica El desconocimiento de los profesionales de la salud en relación a las vacunas indicadas para personas que viven con VIH fue el principal aspecto identificado, lo que generó inseguridad entre los profesionales. Se advierte la necesidad de disponer la educación permanente de los equipos multiprofesionales de servicios especializados y de atención primaria para reducir barreras y aumentar las coberturas de vacunación de esta clientela.

Abstract Objective to identify evidence in the literature about the health professionals' knowledge concerning vaccination of people living with HIV. Method This is an integrative review. In this research, the descriptors used were the following: health personnel, knowledge, vaccination, HIV and its synonyms, without the use of filters, in the Pubmed, Virtual Health Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Embase, Scopus, Science Direct and Cochrane databases. Only primary articles analyzed using the RAYYAN application were included. Results Out of 601 initial publications, only five comprised the final sample, all identified in Pubmed and published between 2013 and 2018, with no Brazilian studies. Most of the publications were related to a specific vaccine and did not address the entire vaccination schedule. Conclusion and implications for the practice The health professionals' lack of knowledge in relation to vaccines indicated to people living with HIV was the main aspect identified, resulting in insecurity among the professionals. There is a need for permanent education of the multidisciplinary teams of specialized services and primary care in order to reduce barriers and to increase vaccination coverage for this clientele.

Síndrome de Ramsay-Hunt: a propósito de dos casos en que se identificó el genoma del virus de la varicela-zóster en líquido cefalorraquídeo / Ramsay-Hunt syndrome: Report of two cases with identification of the varicella zoster virus genome in cerebrospinal fluid

Resumen | Como los otros herpesvirus alfa, el virus de la varicela-zóster (VZV) permanece en estado de latencia en los ganglios neurales después de la infección primaria (varicela). La reactivación de una infección latente por VZV en los ganglios de la raíz dorsal, produce el herpes zóster. La erupción que este provoca se caracteriza por lesiones cutáneas metaméricas que se acompañan de dolor neurítico y comprometen con mayor frecuencia a ancianos y sujetos inmunocomprometidos, en especial, aquellos infectados con el virus de la inmunodeficiencia humana (HIV). Las complicaciones que se observan en esta población de pacientes incluyen neumonía, hepatitis y compromiso del sistema nervioso central (meningitis y encefalitis). Varios síndromes clínicos se asocian con el herpes zóster de localización craneal, incluida la parálisis facial periférica y el síndrome de Ramsay-Hunt, el cual constituye la segunda causa de parálisis facial periférica y tiene una gran variedad de presentaciones clínicas. La parálisis facial se presenta en 60 a 90 % de los casos de síndrome de Ramsay-Hunt, puede preceder o aparecer después de las lesiones cutáneas y tiene peor pronóstico que la parálisis de Bell. Se describen aquí dos casos de herpes zóster del ganglio geniculado, con parálisis facial periférica que coincidió con la aparición de las lesiones cutáneas vesiculosas en el conducto auditivo externo y el pabellón auricular (síndrome de Ramsay-Hunt multimetamérico). En ambos casos, se identificó el genoma del VZV mediante PCR en el líquido cefalorraquídeo (LCR).

Abstract | Like other alpha-herpesviruses, the varicella-zoster virus (VZV) remains latent in the neural ganglia following the primary varicella infection. The reactivation of the VZV in the dorsal root ganglia results in herpes zoster. Herpes zoster eruption is characterized by localized cutaneous lesions and neuralgic pain mostly in older and immunocompromised persons, especially those living with the human immunodeficiency virus (HIV). The most commonly reported complications include VZV pneumonia, meningitis, encephalitis, and hepatitis. Several neurologic syndromes have been described associated with herpes zoster localized in cranial areas including peripheral nerve palsies and the Ramsay-Hunt syndrome, which has a varied clinical presentation and is the second most common cause of peripheral facial paralysis. Facial paralysis in this syndrome occurs in 60 to 90% of cases and it may precede or appear after the cutaneous lesions with a worse prognosis than idiopathic Bell paralysis. Here we present two cases of herpes zoster from the geniculate ganglia with peripheral facial paralysis that appeared simultaneously with vesicular herpetic otic lesions (multimetameric Ramsay-Hunt syndrome). In the two cases, amplifiable varicella-zoster viral DNA was found in the cerebrospinal fluid by RT-PCR Multiplex.