Asunto(s)
Segmento Anterior del Ojo/virología , Herpesvirus Humano 1/fisiología , Interferón gamma/fisiología , Queratitis Herpética/etiología , Síndrome de Necrosis Retiniana Aguda/prevención & control , Animales , Humanos , Queratitis Herpética/inmunología , Síndrome de Necrosis Retiniana Aguda/virologíaRESUMEN
Varicella zoster virus (VZV) is an exclusively human neurotropic alphaherpesvirus. Primary infection causes varicella (chickenpox), after which virus becomes latent in cranial nerve ganglia, dorsal root ganglia, and autonomic ganglia along the entire neuraxis. Years later, in association with a decline in cell-mediated immunity in elderly and immunocompromised individuals, VZV reactivates and causes a wide range of neurologic disease. This article discusses the clinical manifestations, treatment, and prevention of VZV infection and reactivation; pathogenesis of VZV infection; and current research focusing on VZV latency, reactivation, and animal models.
Asunto(s)
Herpesvirus Humano 3/aislamiento & purificación , Virosis/fisiopatología , Virosis/virología , Analgésicos Opioides/uso terapéutico , Antidepresivos/uso terapéutico , Antivirales/uso terapéutico , Varicela/fisiopatología , Varicela/transmisión , Varicela/virología , Ganglios/virología , Herpes Zóster/fisiopatología , Herpes Zóster/transmisión , Herpes Zóster/virología , Vacuna contra el Herpes Zóster/administración & dosificación , Humanos , Neuralgia Posherpética/tratamiento farmacológico , Neuralgia Posherpética/virología , Síndrome de Necrosis Retiniana Aguda/líquido cefalorraquídeo , Síndrome de Necrosis Retiniana Aguda/prevención & control , Síndrome de Necrosis Retiniana Aguda/virología , Factores de Tiempo , Virosis/prevención & controlRESUMEN
We reviewed the course of 54 patients who had unilateral acute retinal necrosis at initial examination. Thirty-one patients were treated with acyclovir, whereas 23 were not. Of the 31 patients treated with acyclovir, 27 (87.1%) had fellow eyes that remained disease-free throughout a median follow-up of 12 months. Of the 23 patients not treated with acyclovir, seven (30.4%) had fellow eyes that remained disease-free throughout a median follow-up of 11 months. Survival analysis indicated that the fellow eyes of the group of patients treated with acyclovir were more likely to remain disease-free than the fellow eyes of the group not treated with acyclovir (P = .0013). Two years after initial onset, the proportion of fellow eyes that remained disease-free was 75.3% for the group treated with acyclovir and 35.1% for the group not treated with acyclovir. These results suggest that acyclovir treatment reduces the risk of involvement of the fellow eye in patients with acute retinal necrosis.