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1.
Curr Top Microbiol Immunol ; 438: 103-134, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-34904194

RESUMO

Latency and reactivation in neurons are critical aspects of VZV pathogenesis that have historically been difficult to investigate. Viral genomes are retained in many human ganglia after the primary infection, varicella; and about one-third of the naturally infected VZV seropositive population reactivates latent virus, which most often clinically manifests as herpes zoster (HZ or Shingles). HZ is frequently complicated by acute and chronic debilitating pain for which there remains a need for more effective treatment options. Understanding of the latent state is likely to be essential in the design of strategies to reduce reactivation. Experimentally addressing VZV latency has been difficult because of the strict human species specificity of VZV and the fact that until recently, experimental reactivation had not been achieved. We do not yet know the neuron subtypes that harbor latent genomes, whether all can potentially reactivate, what the drivers of VZV reactivation are, and how immunity interplays with the latent state to control reactivation. However, recent advances have enabled a picture of VZV latency to start to emerge. The first is the ability to detect the latent viral genome and its expression in human ganglionic tissues with extraordinary sensitivity. The second, the subject of this chapter, is the development of in vitro human neuron systems permitting the modeling of latent states that can be experimentally reactivated. This review will summarize recent advances of in vitro models of neuronal VZV latency and reactivation, the limitations of the current systems, and discuss outstanding questions and future directions regarding these processes using these and yet to be developed models. Results obtained from the in vitro models to date will also be discussed in light of the recent data gleaned from studies of VZV latency and gene expression learned from human cadaver ganglia, especially the discovery of VZV latency transcripts that seem to parallel the long-studied latency-associated transcripts of other neurotropic alphaherpesviruses.


Assuntos
Varicela , Herpes Zoster , Humanos , Herpesvirus Humano 3/genética , Ativação Viral/genética , Latência Viral/genética , Herpes Zoster/patologia , Neurônios/patologia
2.
Curr Top Microbiol Immunol ; 438: 223-246, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35102438

RESUMO

The live attenuated varicella vaccine is intended to mimic the tempo and nature of the humoral and cell-mediated immune responses to varicella infection. To date, two doses of varicella vaccine administered in childhood have been very effective in generating varicella-zoster virus (VZV) immune responses that prevent natural infection for at least several decades. After primary infection, the infecting VZV establishes latency in sensory and cranial nerve ganglia with the potential to reactivate and cause herpes zoster. Although, the immune responses developed during varicella are important for preventing herpes zoster they wane with increasing age (immune senescence) or with the advent of immune suppression. Protection can be restored by increasing cell-mediated immune responses with two doses of an adjuvanted recombinant VZV glycoprotein E vaccine that stimulates both VZV-and gE-specific immunity. This vaccine provides ~85-90% protection against herpes zoster for 7-8 years (to date).


Assuntos
Varicela , Vacina contra Herpes Zoster , Herpes Zoster , Humanos , Herpesvirus Humano 3 , Varicela/prevenção & controle , Vacina contra Varicela , Herpes Zoster/prevenção & controle , Vacinas Atenuadas , Imunidade Celular
3.
Curr Top Microbiol Immunol ; 438: 135-161, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35292858

RESUMO

Varicella-zoster virus (VZV) is a human-restricted virus, which raises obstacles to research. The strict human tropism limits knowledge about its pathogenesis and creates challenges for evaluating antiviral treatments and vaccines. The development of humanized mouse models was driven by the need to address these challenges. Here, we summarize the humanized mouse models with xenografts of thymus/liver organoids, skin, dorsal root ganglia, and lung tissues. These models revealed VZV ORFs involved in cell tropism and pathogenesis in differentiated tissues, and made it possible to evaluate antiviral compounds in a mammalian system. Further development of skin organ culture techniques have the added benefit of lower cost and greater speed than mouse models. Human tissues, both in humanized mice and in ex vivo models, will continue to be necessary to study VZV in the tissue microenvironements to which it is adapted.


Assuntos
Herpes Zoster , Herpesvirus Humano 3 , Camundongos , Humanos , Animais , Camundongos SCID , Herpes Zoster/patologia , Xenoenxertos , Modelos Animais de Doenças , Antivirais , Mamíferos
4.
J. Health Biol. Sci. (Online) ; 10(1): 1-9, 01/jan./2022. ilus, tab, graf
Artigo em Inglês | LILACS | ID: biblio-1378522

RESUMO

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.


Assuntos
Herpes Zoster , Registros Médicos , Doença , Epidemiologia , Herpesvirus Humano 3 , Hospitalização , Pacientes Internados , Métodos
5.
Zhonghua Yi Xue Za Zhi ; 102(40): 3186-3191, 2022 Nov 01.
Artigo em Chinês | MEDLINE | ID: mdl-36319172

RESUMO

Objective: To evaluate the efficacy and safety of lidocaine plaster combined with gabapentin in the treatment of herpes zoster neuralgia (HZN). Methods: A total of 93 patients diagnosed with HZN from June 4, 2021 to January 5, 2022 in the Department of Pain Clinic of Nanjing Drum Tower Hospital were selected, and their gender was not limited. They were divided into 3 groups by random number table method: group A (n=32) prescribed gabapentin alone, group B (n=30) lidocaine plaster alone, and group C (n=31) lidocaine plaster combined with gabapentin. After excluding patients who did not meet the criteria, there were 28 cases in group A, 28 cases in group B, and 29 cases in group C. The visual analogue scale (VAS), the short-form McGill pain questionnaire (SF-MPQ) score, and drug dosage and adverse reaction in each group at pre-treatment (T0), post-treatment in one week (T1), in two weeks (T2), in four weeks (T4), and in 12 weeks (T12) were recorded and evaluated; Pittsburgh Sleep Quality Index (PSQI) score and Medical Outcomes Study short-form 36 (SF-36) score at T0, T4, and T12 were recorded. Adverse reactions and drug dosage in each group were documented. Repeated measures ANOVA was used to compare the curative effects of the three groups at different time points before and after treatment. Results: The ages of the three groups of patients were (67.8±10.0), (60.9±11.4) and (63.5±12.5) years old respectively (P=0.318), and the proportions of men were 46.4 % (13 cases), 35.7% (10 cases) and 44.8 % (13 cases), respectively (P=0.472). After treatment, the VAS scores and SF-MPQ scores of patients in the three groups were decreased at each time point compared with those before treatment (all P<0.05), the VAS and SF-MPQ scores of patients in group C at T12 time point were 1.2±0.4 and 5.2±2.4 respectively, which were lower than those of patients in groups A and B (both P<0.05). The dosages of gabapentin and lidocaine plaster in group C were lower than those in groups A and B at each time point after treatment (all P<0.05). The PSQI scores of patients in the three groups at T4 and T12 were lower than those before treatment (all P<0.05). The PSQI scores of patients in group C at T4 and T12 were 5.7±1.2 and 4.5±1.2, which were lower than those of patients in groups A and B. (all P<0.05), The SF-36 scores of patients in three groups at T4 and T12 were higher than those before treatment (all P<0.05), and the SF-36 scores of group C at T4 and T12 were 91.7±8.5, 93.1±6.3, which were higher than that of patients in groups A and B (both P<0.05). The incidence of adverse reactions in the three groups were 35.7% (9 cases), 10.7% (3 cases), and 13.8% (4 cases) respectively (P<0.05), the adverse reactions in groups B and C were less than those in group A (P<0.05), and there was no statistical difference between groups B and C (P>0.05). Conclusion: Lidocaine plaster combined with gabapentin has better analgesic effect in the treatment of HZN, with less incidence of adverse reactions, and can reduce the dosage of systemic drugs, improve patients' sleep and quality of life, and thus could provide a safe and effective method for the treatment of HZN.


Assuntos
Herpes Zoster , Neuralgia , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Gabapentina/efeitos adversos , Herpes Zoster/induzido quimicamente , Herpes Zoster/tratamento farmacológico , Lidocaína , Neuralgia/induzido quimicamente , Neuralgia/tratamento farmacológico , Qualidade de Vida , Resultado do Tratamento , Feminino
7.
Am J Case Rep ; 23: e937559, 2022 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-36409660

RESUMO

BACKGROUND Herpes zoster caused by the reactivation of latent varicella-zoster virus is thought to result from the waning of specific cell-mediated immunity. Scrub typhus, an acute infectious disease caused by Orientia tsutsugamushi, affects multiple organs and is characterized by microangiopathies that result in significant vascular leakage and subsequent end-organ injury. Very few cases of reactivation of the varicella-zoster virus following scrub typhus occurrence have been reported. Furthermore, no previous studies have directly investigated whether Orientia tsutsugamushi infection is a potential risk factor for herpes zoster. CASE REPORT We present the case of a 64-year-old woman without a previous illness who simultaneously developed herpes zoster of the thoracic dermatome and scrub typhus. Clinical symptoms of scrub typhus appeared during the treatment course for herpes zoster symptoms. Based on positive virus antibody test results, the patient was diagnosed with scrub typhus. This is a unique case of reactivation of the varicella-zoster virus that occurred during a silent incubation period for scrub typhus. CONCLUSIONS This report indicates the possibility of reactivation of latent varicella-zoster virus following Orientia tsutsugamushi infection, although the relationship between the 2 remains undetermined. Physicians should be aware that scrub typhus might be a potential determinant of varicella-zoster virus reactivation.


Assuntos
Herpes Zoster , Orientia tsutsugamushi , Tifo por Ácaros , Feminino , Humanos , Pessoa de Meia-Idade , Tifo por Ácaros/diagnóstico , Tifo por Ácaros/complicações , Herpesvirus Humano 3 , Período de Incubação de Doenças Infecciosas , Herpes Zoster/tratamento farmacológico
8.
JAAPA ; 35(12): 13-18, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36346926

RESUMO

ABSTRACT: Herpes zoster, or shingles, caused by a reactivation of the chickenpox virus, can occur in patients of any age, but is more common in older adults. Patient history is critical in reaching a diagnosis, not only to manage the outbreak effectively, but also to prevent severe complications such as dissemination of the virus into the central nervous system. This article describes recent changes in diagnostic testing, treatment, prevention, and practice guidelines as well as the approach clinicians should take when evaluating patients with herpes zoster and assessing risk for complications.


Assuntos
Herpes Zoster , Herpesvirus Humano 3 , Humanos , Idoso , Herpesvirus Humano 3/fisiologia , Herpes Zoster/diagnóstico , Herpes Zoster/tratamento farmacológico , Herpes Zoster/prevenção & controle , Atenção Primária à Saúde
9.
Vaccine ; 40(50): 7182-7186, 2022 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-36336528

RESUMO

OBJECTIVE(S): To estimate HZ vaccine coverage in Australia among older Australians and to identify potential barriers to vaccination. DESIGN: Analysis of data from three cross-sectional surveys administered online between 2019 and 2020. SETTING AND PARTICIPANTS: Adults aged 65 and over residing in Australia. MAIN OUTCOME MEASURES: Self-reported herpes zoster vaccination. RESULTS: Among the 744 adults aged 65 and over in this sample, 32% reported being vaccinated for HZ, including 23% of participants aged 65-74, 55% of participants aged 75-84, and 0% for participants aged 85 and above. Those who are vaccinated with other immunisations are more likely to have received HZ vaccine, including seasonal influenza (OR = 4.41, 95 % CI: 2.44-7.98) and pneumococcal vaccines (OR = 4.43, 95 % CI: 2.92 - 6.75). Participants with a history of certain conditions, such as stroke (OR = 2.26, 95 % CI: 1.13-4.49), were more likely to be vaccinated against HZ. Participants that reported smoking tobacco daily were less likely to be vaccinated against HZ (OR = 0.48, 95 % CI: 0.26-0.89). Participants were less likely to be vaccinated against HZ if they preferred to develop immunity 'naturally' (OR = 0.29, 95 % CI: 0.15 - 0.57) or expressed distrust of vaccines (OR = 0.34, 95 % CI: 0.13-0.91). CONCLUSION(S): Further research is required to understand the barriers to HZ vaccine uptake. Increasing the funding eligibility for those who are at risk of complications from shingles, or lowering the age of eligibility, may increase vaccine coverage.


Assuntos
Vacina contra Herpes Zoster , Herpes Zoster , Humanos , Adulto , Austrália/epidemiologia , Estudos Transversais , Vacinação , Herpes Zoster/epidemiologia , Herpes Zoster/prevenção & controle
10.
Vaccine ; 40(50): 7187-7190, 2022 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-36347721

RESUMO

In 2018, CDC recommended a highly efficacious adjuvanted recombinant zoster vaccine (RZV) as a 2-dose series for prevention of herpes zoster (HZ) for immunocompetent persons age ≥ 50 years, with the 2nd dose recommended 2-6 months after the 1st dose. We estimated second-dose RZV series completion in the U.S. among 50-64-year-olds using two administrative databases. Second-dose RZV series completion was ∼70% within 6-months and 80% within 12-months of first dose. Among those who received only 1 RZV dose with at least 12 months of follow-up time, 96% had a missed opportunity for a second-dose vaccination, defined as a provider or pharmacy visit, among whom 36% had a visit for influenza or pneumococcal vaccination within 2-12 months of their first-dose of RZV. We found that RZV series completion rates in 50-64-year-olds was high. Availability of RZV at pharmacies has potentially helped increase series completion, but missed opportunities remain.


Assuntos
Vacina contra Herpes Zoster , Herpes Zoster , Vacinas contra Influenza , Influenza Humana , Adulto , Humanos , Estados Unidos , Herpes Zoster/prevenção & controle , Vacinas Sintéticas
11.
Zhonghua Yi Xue Za Zhi ; 102(42): 3395-3400, 2022 Nov 15.
Artigo em Chinês | MEDLINE | ID: mdl-36372770

RESUMO

Objective: To evaluate the quality of life and influencing factors of patients with herpes zoster (HZ) seen in hospitals. Methods: Based on Zoster Brief Pain Inventory (ZBPI) and Five-level EuroQol Five-dimensional Questionnaire (EQ-5D-5L), a cross-sectional survey was conducted to evaluate the pain severity and quality of life of 332 HZ cases seen in 22 hospitals of Lu'an City (Anhui Province), Zibo City (Shandong Province) and Tongchuan City (Shaanxi Province) from October to December 2021. The censored least absolute deviations (CLAD) model was used to analyze the related factors affecting the changes of patients' health utility values. Results: The 45.5% of 332 HZ cases were male. The median (Q1,Q3) age was 59 (50, 68) years. 59.64% of them assessed by ZBPI had moderate to severe pain in the past 24 hours (worst pain score≥5), and that of PHN cases was 84.8%(39/46). 77.7% (258/332), 77.4% (257/332) and 74.1% (246/332) of all patients reported that pain interfered with sleep, mood and general activities, respectively. Aging [ß40-49y (95%CI)=-0.11 (-0.15, -0.08); ß50-59y (95%CI)=-0.03 (-0.05, 0.00); ß60-69y (95%CI)=-0.09 (-0.12, -0.06); ß70-90y(95%CI)=-0.16 (-0.19, -0.12)], working status (unemployed) [ßfarmer (95%CI)=0.15 (0.13, 0.18); ßretirees(95%CI)=0.21 (0.18, 0.24); ßemployee (95%CI)=0.13 (0.10, 0.16) ], complications[ßPHN (95%CI)=-0.08 (-0.13, -0.04); ßother complications (95%CI)=-0.12 (-0.15, -0.08)], within 30 days after onset [ß(95%CI)=-0.01 (-0.03, 0.01)] and treatment [ßother complications (95%CI)=-0.09 (-0.11, -0.06)] were related factors for the decline of health utility value (all P values <0.05). Conclusions: More than half of the patients with HZ had moderate to severe pain in the past 24 hours, which had a serious negative impact on the physical and mental health of the patients. Elderly patients, acute patients and patients with complications had lower health utility values and worse health status. We suggest that eligible people be vaccinated with HZ vaccine as soon as possible.


Assuntos
Herpes Zoster , Qualidade de Vida , Humanos , Masculino , Idoso , Feminino , Radioisótopos de Ítrio , Estudos Transversais , Herpes Zoster/complicações , Herpes Zoster/prevenção & controle , Herpesvirus Humano 3 , Dor/etiologia , Fatores de Risco
12.
BMC Musculoskelet Disord ; 23(1): 961, 2022 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-36348331

RESUMO

BACKGROUND: The reactivation of herpes zoster (HZ) is associated with disease stress. However, the relationship between chondromalacia patella (CMP) and HZ remains poorly understood. This study investigated the relationship between CMP and the risk of developing HZ. METHODS: Data were collected from the Taiwan's National Health Insurance Research Database. Patients with CMP diagnosed between 2000 and 2017 were assigned to the case group; patients without CMP were randomly selected from the same database and paired with controls matched by age and sex. The primary outcome was a diagnosis of HZ. All patients were followed until their diagnosis of HZ, their withdrawal from the NHI program, their death, or the end of 2017, whichever was earliest. The risk of developing HZ was compared between the case and control groups. RESULTS: In total, 22,710 patients with CMP and 90,840 matched controls were enrolled. The overall incidence rates of HZ in the CMP and control cohorts were 7.94 and 7.35 per 1,000 person-years, respectively. After potential confounders were controlled for, the case group exhibited a higher risk of HZ than did the control group [adjusted hazard ratio (aHR) = 1.06, p < 0.05]. In a stratification analysis by age, patients over 65 years old in the CMP group exhibited a higher risk of HZ than did those in the control group (aHR = 1.22, p < 0.01). In a stratification analysis by sex, women with CMP were at greater risk of developing HZ than women without CMP (aHR = 1.18, p < 0.01). CONCLUSION: Patients with CMP, especially elder adults and women, exhibited a higher risk of HZ. The HZ risk of patients with CMP should thus be assessed, and the necessity of HZ vaccination should be informed.


Assuntos
Doenças das Cartilagens , Herpes Zoster , Adulto , Humanos , Feminino , Idoso , Patela , Estudos Retrospectivos , Herpes Zoster/epidemiologia , Herpes Zoster/complicações , Incidência , Citidina Monofosfato , Fatores de Risco
13.
Nat Commun ; 13(1): 6957, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36376285

RESUMO

Herpes zoster is a localized skin infection caused by reactivation of latent varicella-zoster virus. Tissue-resident T cells likely control skin infections. Zoster provides a unique opportunity to determine if focal reinfection of human skin boosts local or disseminated antigen-specific tissue-resident T cells. Here, we show virus-specific T cells are retained over one year in serial samples of rash site and contralateral unaffected skin of individuals recovered from zoster. Consistent with zoster resolution, viral DNA is largely undetectable on skin from day 90 and virus-specific B and T cells decline in blood. In skin, there is selective infiltration and long-term persistence of varicella-zoster virus-specific T cells in the rash site relative to the contralateral site. The skin T cell infiltrates express the canonical tissue-resident T cell markers CD69 and CD103. These findings show that zoster promotes spatially-restricted long-term retention of antigen-specific tissue-resident T cells in previously infected skin.


Assuntos
Exantema , Herpes Zoster , Humanos , Herpesvirus Humano 3 , Pele , DNA Viral/genética
14.
BMC Infect Dis ; 22(1): 888, 2022 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-36435780

RESUMO

BACKGROUND: Herpes zoster increases the burden on the elderly in an aging society. Although an effective vaccine licensed by China Food and Drug Administration in 2019 was introduced into the market in June 2020, the willingness and influencing factors of herpes zoster vaccines in Chinese adults ≥ 50-years-old during coronavirus disease-2019 pandemic are yet to be elucidated. METHODS: An online questionnaire survey was conducted using a simple random sampling method in October 2021 for viewers of the broadcast program. A binary logistic regression and multiple response analysis were conducted for herpes zoster vaccine and vaccination willingness. Pareto's graphs were plotted to present the multiple-choice questions of influencing factors. RESULTS: A total of 3838 eligible participants were included in this study. Among them, 43.02% intended to be vaccinated, including 10.34% self-reported about receiving at least one shot of shingles vaccine, 30.22% declined, and 26.76% were hesitant. This population comprised a large proportion of middle-aged and older people (≥ 50-years-old) who have not experienced an episode of herpes zoster (54.98%) or are unaware of the virus (33.22%). The strongest determinants of vaccine hesitancy among older people were education background of Master's degree or above compared to senior high or equivalent and below, personal monthly income < 3000 RMB compared to 3000-5999 RMB, and living in a rural area. CONCLUSIONS: The willingness to get shingles vaccines can be improved further. Professional education and credible recommendation might prompt the elderly to improve their willingness and reassure them of the safety and efficacy of the vaccine. Also, accessibility and affordability should also be improved in the future.


Assuntos
COVID-19 , Vacina contra Herpes Zoster , Herpes Zoster , Pessoa de Meia-Idade , Idoso , Adulto , Humanos , Herpes Zoster/epidemiologia , Herpesvirus Humano 3 , China
15.
Curr Sports Med Rep ; 21(11): 386-390, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36342391

RESUMO

ABSTRACT: Herpes zoster (HZ), shingles, is caused by the varicella-zoster virus (VZV). HZ develops as a reactivation of latent VZV and is characterized by a painful, vesicular rash typically manifesting in a dermatomal distribution on the arms, trunk or face. HZ occurs in individuals who had primary VZV disease (chickenpox) as a child or in those who have received live, attenuated VZV vaccine. HZ is common in the elderly and the immunocompromised, with age being the single greatest risk factor. The incidence of HZ in children is 74/100,000 person years for the unvaccinated and 38/100,000 person years for the vaccinated. We discuss the case of a 12-year-old soccer player with HZ who presented with right arm pain after a putative traumatic event. Diagnosis was made after two emergency department visits where the condition was not identified. HZ should be considered in the clinician's differential even in immunocompetent, vaccinated children.


Assuntos
Herpes Zoster , Dor , Criança , Humanos , Braço , Atletas , Herpes Zoster/complicações , Herpesvirus Humano 3 , Dor/diagnóstico , Futebol
16.
JAMA Netw Open ; 5(11): e2242240, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36383382

RESUMO

Importance: Herpes zoster infection after COVID-19 vaccination has been reported in numerous case studies. It is not known whether these cases represent increased reporting or a true increase in risk. Objective: To assess whether COVID-19 vaccination is associated with an increased risk of herpes zoster infection. Design, Setting, and Participants: This cohort study used a self-controlled risk interval (SCRI) design to compare the risk of herpes zoster in a risk interval of 30 days after COVID-19 vaccination or up to the date of the second vaccine dose with a control interval remote from COVID-19 vaccination (defined as 60-90 days after the last recorded vaccination date for each individual, allowing for a 30-day washout period between control and risk intervals). A supplemental cohort analysis was used to compare the risk of herpes zoster after COVID-19 vaccination with the risk of herpes zoster after influenza vaccination among 2 historical cohorts who received an influenza vaccine in the prepandemic period (January 1, 2018, to December 31, 2019) or the early pandemic period (March 1, 2020, to November 30, 2020). Data were obtained from Optum Labs Data Warehouse, a US national deidentified claims-based database. A total of 2 039 854 individuals who received any dose of a COVID-19 vaccine with emergency use authorization (BNT162b2 [Pfizer-BioNTech], mRNA-1273 [Moderna], or Ad26.COV2.S [Johnson & Johnson]) from December 11, 2020, through June 30, 2021, were eligible for inclusion. Individuals included in the SCRI analysis were a subset of the COVID-19-vaccinated cohort who had herpes zoster during either a risk or control interval. Exposures: Any dose of a COVID-19 vaccine. Main Outcomes and Measures: Incident herpes zoster, defined by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes and a prescription of a new antiviral medication or a dose increase in antiviral medication within 5 days of diagnosis. Results: Among 2 039 854 individuals who received any dose of a COVID-19 vaccine during the study period, the mean (SD) age was 43.2 (16.3) years; 1 031 149 individuals (50.6%) were female, and 1 344 318 (65.9%) were White. Of those, 1451 patients (mean [SD] age, 51.6 [12.6] years; 845 [58.2%] female) with a herpes zoster diagnosis were included in the primary SCRI analysis. In the SCRI analysis, COVID-19 vaccination was not associated with an increased risk of herpes zoster after adjustment (incidence rate ratio, 0.91; 95% CI, 0.82-1.01; P = .08). In the supplementary cohort analysis, COVID-19 vaccination was not associated with a higher risk of herpes zoster compared with influenza vaccination in the prepandemic period (first dose of COVID-19 vaccine: hazard ratio [HR], 0.78 [95% CI, 0.70-0.86; P < .001]; second dose of COVID-19 vaccine: HR, 0.79 [95% CI, 0.71-0.88; P < .001]) or the early pandemic period (first dose of COVID-19 vaccine: HR, 0.89 [95% CI, 0.80-1.00; P = .05]; second dose: HR, 0.91 [95% CI, 0.81-1.02; P = .09]). Conclusions and Relevance: In this study, there was no association found between COVID-19 vaccination and an increased risk of herpes zoster infection, which may help to address concerns about the safety profile of the COVID-19 vaccines among patients and clinicians.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Herpes Zoster , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ad26COVS1 , Antivirais/uso terapêutico , Vacina BNT162 , Estudos de Coortes , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Herpes Zoster/epidemiologia , Herpes Zoster/prevenção & controle , Herpes Zoster/tratamento farmacológico , Vacina contra Herpes Zoster/efeitos adversos , Influenza Humana/tratamento farmacológico
17.
Clin Neurol Neurosurg ; 223: 107496, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36334554

RESUMO

INTRODUCTION: Postherpetic neuralgia (PHN) is the most common and severe complication of acute herpes zoster. Early treatment of herpes zoster neuralgia is of great significance to reduce the incidence of PHN. This retrospective study evaluated the efficacy and safety of the combination of high-voltage pulsed radiofrequency (PRF) and oxygen-ozone(O2-O3) injection in patients with acute zoster neuralgia (AZN) who failed to respond to conservative treatment. METHODS: One-hundred patients diagnosed with AZN were classified into two groups (high-voltage PRF group [HP group, n = 50] and high-voltage PRF combined with O2-O3 injection group [HPO group, n = 50]) based on different treatment methods. Therapeutic effectiveness was assessed using a numerical rating scale (NRS) and the Pittsburgh Sleep Quality Index (PSQI). The dosages of gabapentin and tramadol (mg/d) before treatment and after 1 week and 1, 3, and 6 months of treatment were measured. The incidence of clinically meaningful PHN after treatment was also recorded. RESULTS: Pain intensity and sleep quality in both groups at all time points improved after treatment compared to before treatment (P < 0.05). After 1 week and 1 month of treatment, NRS and PSQI scores in both groups decreased, but the differences were not statistically significant (P > 0.05). NRS, PSQI scores, and the dosages of gabapentin and tramadol decreased more significantly in the HPO group than those in the HP group after 3 months (P < 0.05). The incidence of PHN was significantly lower in the HPO group than in the HP group (P < 0.05). There were no significant differences in adverse events between the groups. CONCLUSIONS: High-voltage PRF is a safe and effective method for treating AZN. The combination of high-voltage PRF and O2-O3 injection is superior to high-voltage PRF alone for treating late-stage AZN. This approach could be recommended as an alternative treatment for patients with refractory AZN and could significantly reduce the risk of PHN.


Assuntos
Herpes Zoster , Neuralgia Pós-Herpética , Neuralgia , Ozônio , Tratamento por Radiofrequência Pulsada , Tramadol , Humanos , Tratamento por Radiofrequência Pulsada/métodos , Estudos Retrospectivos , Ozônio/uso terapêutico , Oxigênio , Gabapentina , Neuralgia Pós-Herpética/tratamento farmacológico , Herpes Zoster/complicações , Neuralgia/terapia
18.
MMW Fortschr Med ; 164(Suppl 3): 74, 2022 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-36413302

Assuntos
Herpes Zoster , Humanos
19.
Viruses ; 14(11)2022 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-36423126

RESUMO

Varicella-zoster virus (VZV) infection of neuronal cells and the activation of cell-intrinsic antiviral responses upon infection are still poorly understood mainly due to the scarcity of suitable human in vitro models that are available to study VZV. We developed a compartmentalized human-induced pluripotent stem cell (hiPSC)-derived neuronal culture model that allows axonal VZV infection of the neurons, thereby mimicking the natural route of infection. Using this model, we showed that hiPSC-neurons do not mount an effective interferon-mediated antiviral response following VZV infection. Indeed, in contrast to infection with Sendai virus, VZV infection of the hiPSC-neurons does not result in the upregulation of interferon-stimulated genes (ISGs) that have direct antiviral functions. Furthermore, the hiPSC-neurons do not produce interferon-α (IFNα), a major cytokine that is involved in the innate antiviral response, even upon its stimulation with strong synthetic inducers. In contrast, we showed that exogenous IFNα effectively limits VZV spread in the neuronal cell body compartment and demonstrated that ISGs are efficiently upregulated in these VZV-infected neuronal cultures that are treated with IFNα. Thus, whereas the cultured hiPSC neurons seem to be poor IFNα producers, they are good IFNα responders. This could suggest an important role for other cells such as satellite glial cells or macrophages to produce IFNα for VZV infection control.


Assuntos
Varicela , Herpes Zoster , Células-Tronco Pluripotentes Induzidas , Interferon-alfa , Neurônios , Humanos , Herpesvirus Humano 3/fisiologia , Células-Tronco Pluripotentes Induzidas/virologia , Interferon-alfa/imunologia , Neurônios/virologia , Células Cultivadas
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