Shreya Parkar, Prajakta Kegade, Akshay Gade, Rutuja Sawant
Miss. Shreya Parkar*, Miss. Prajakta Kegade, Mr. Akshay Gade, Miss. Rutuja Sawant
Department of Pharmaceutics, M Pharmacy, University of Mumbai, Vidya Nagari, Kalina, Santacruz-East, Mumbai, Maharashtra 400098.
Volume - 11,
Issue - 2,
Year - 2021
Varicella zoster virus is one of the eight herpes viruses that are pathogenic only for humans. It is alpha-herpes zoster of the genus varicellovirus, which causes varicella (chickenpox) and zoster (shingles). Herpes zoster is described as a multivesicular eruptive rash that follows a single or multiple adjacent dermatomal distribution. VZV infection begins with replication in epithelial cells of upper respiratory mucosa, which is followed by widely distributed vesicular rash. Cell-mediated immunity plays a role in this reactivation. Patients with conditions that decrease cell-mediated immunity are 20 to 100 times more prone to develop herpes zoster. It is often accompanied by acute pain and itchiness. Complications may be dermatological (e.g. secondary bacterial infection), neurological (e.g. long-term pain, segmental paresis, stroke), ophthalmological (e.g. keratitis, iridocyclitis, secondary glaucoma) or visceral (e.g. pneumonia, hepatitis). Most common Complications of the infection are post herpetic neuralgia and ophthalmic zoster. Treatment includes antiviral medications such as acyclovir, famciclovir, and valacyclovir given within 72 hours of symptom has been shown to reduce severity and complications associated with herpes zoster and post-herpetic neuralgia, both these diseases are vaccine preventable. Before the invention of the recombinant VZV vaccine, live VZV vaccine was the recommended immunization, approved for adults 50 years and older.
Cite this article:
Shreya Parkar, Prajakta Kegade, Akshay Gade, Rutuja Sawant. An Overview of Herpes zoster: Aetiology, Pathogenesis and Treatment. Asian Journal of Research in Pharmaceutical Sciences. 2021; 11(2):140-4. doi: 10.52711/2231-5659.2021-11-2-8
Shreya Parkar, Prajakta Kegade, Akshay Gade, Rutuja Sawant. An Overview of Herpes zoster: Aetiology, Pathogenesis and Treatment. Asian Journal of Research in Pharmaceutical Sciences. 2021; 11(2):140-4. doi: 10.52711/2231-5659.2021-11-2-8 Available on: https://ajpsonline.com/AbstractView.aspx?PID=2021-11-2-8
1. Lal H, Cunningham AL, Godeaux O, Chlibek R, Diez-Domingo J, Hwang SJ, et al. Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. N Engl J Med 2015; 372: 2087-96.
2. Cohen JI, Brunell PA, Straus SE, Krause PR. Recent advances in varicella-zoster virus infection. Ann Intern Med. 1999; 30: 922–932.
3. Varicella zoster virus transmission in the vaccine era: unmasking the role of herpes zoster. Bloch KC, Johnson JGJ Infect Dis. 2012 May 1; 205(9): 1331-3.
4. Jung BF, Johnson RW, Griffin DR, Dworkin RH. Risk factors for postherpetic neuralgia in patients with herpes zoster. Neurology 2004; 62: 1545-51.
5. Shingrix package insert. Research Triangle Park, NC: GlaxoSmithKline; October 2017.
6. Gnann JW, Whitley RJ. Herpes zoster. N Eng J Med. 2002; 347(5): 340-346.
7. Ogunjimi B, Van Damme P, Beutels P. Herpes zoster risk reduction through exposure to chickenpox patients: A Systematic multidisciplinary review. PLoS One 2013; 8: e66485.
8. Tanuseputro P., Zagorski B., Chan K., Kwong J. (2011) Population-based incidence of herpes zoster after introdu10.ction of a publicly funded varicella vaccination program. Vaccine 29: 8580–8584.
9. Viner K., Perella D., Lopez A., Bialek S., Newbern C., Pierre R., et al. Transmission of varicella zoster virus from individuals with herpes zoster or varicella in school and day care settings. J Infect Dis (2012) 205: 1336–1341.
10. Strommen GL, Pucino F, Tight RR, Beck CL. Human infection with herpes zoster: Etiology, pathophysiology, diagnosis, clinical course, and treatment. Pharmacotherapy 1988; 8: 52-68.
11. Johnson RW. Herpes zoster and postherpetic neuralgia. Expert Rev Vaccines 2010; 9: 216.
12. Arvin A. Aging, immunity, and the varicella-zoster virus. N Engl J Med 2005; 352: 22667.
13. Gilden DH, et al. Varicella-zoster virus DNA in human sensory ganglia. Nature. 1983; 306: 478–480.
14. Takahashi M. Clinical overview of varicella vaccine: development and early studies. Pediatrics. 1986; 78: 736–741.
15. Johnson RW, Alvarez-Pasquin MJ, Bijl M, Franco E, Gaillat J, Clara JG, et al. Herpes zoster epidemiology, management, and disease and economic burden in europe: A multidisciplinary perspective. Ther Adv Vaccines 2015; 3: 109-20.
16. Diez-Domingo J, Weinke T, Garcia de Lomas J, Meyer CU, Bertrand I, Eymin C, et al. Comparison of intramuscular and subcutaneous administration of a herpes zoster live-attenuated vaccine in adults aged ≥50 years: A randomised non-inferiority clinical trial. Vaccine 2015; 33: 789-95.
17. Jeon YH. Herpes zoster and postherapeutic neuralgia: practicle consideration for prevention and treatment Korean j pain 2015; 177-84
18. Fields HL, Rowbotham M, Baron R. Postherpetic neuralgia: Irritable nociceptors and deafferentation. Neurobiol Dis1998; 5: 209-27.
19. Boron R. Mechanism of post therapeutic neuralgia, 2008; 140: 395-6.
20. Macmillan Publishers Ltd, Nature Reviews Microbiology, Zerboni L et al., Molecular mechanisms of varicella zoster virus pathogenesis, 2014, 12, 197210.
21. Gnann JW Jr, Whitley RJ. Clinical practice. Herpes zoster. N Engl J Med. 2002; 347(5): 340–346.
22. Boron R. Mechanism of post therapeutic neuralgia, 2008; 140: 395-6.
23. Gilden DH, et al. Varicella-zoster virus DNA in human sensory ganglia. Nature. This study provides the first evidence of VZV latency in neurons, using in situ hybridization to detect VZV genomes. 1983; 306: 478– 480
24. Arvin, AM.; Gilden, D. Fields Virology. 6. Knipe, D.; Howley, P., editors. Lippincott Williams & Wilkins; 2013. p. 2015-2057.
25. Cohen, J., S. Straus, and A. Arvin (ed.) Lippincott Williams & Wilkins, Philadelphia, PA, Varicella-zoster virus replication, pathogenesis, and management, 5th ed., 2007, vol. 2.
26. Roizman, B., D. M. Knipe, and R. J. Whitley. Herpes simplex viruses. In D. M. Knipe, P. M. Howley, D. E. Griffin, R. A. Lamb, M. A. Martin, B. Roizman, and S. E. Straus (ed.), Fields virology, 5th ed., vol. 1. 2007
27. Ku CC, et al. Varicella-zoster virus transfer to skin by T cells and modulation of viral replication by epidermal cell interferon-α. J Exp Med. 2004; 200:917–925.
28. Gilden DH, et al. Varicella-zoster virus DNA in human sensory ganglia. Nature. 1983; 306: 478– 480.
29. Weibel RE, et al. Live attenuated varicella virus vaccine: efficacy trial in healthy children. N Engl J Med. 1984; 310: 1409–1415.
30. Chen, J. J., Zhu, Z., Gershon, A. A., & Gershon, M. D. Mannose 6-phosphate receptor dependence of varicella zoster virus infection in vitro and in the epidermis during varicella and zoster. Cell, (2004). 119(7), 915-926.
31. Dworkin RH, Schmader KE. Treatment and prevention of postherpetic neuralgia. Clin Infect Dis 2003; 36: 877-2.
32. Panlilio LM, Christo PJ, Raja SN. Current management of Post herpetic Neuralgia. Neurologist 2002; 8: 339-50.
33. Davison, A. J., and J. E. Scott. 1986. The complete DNA sequence of varicella-zoster virus. J. Gen. Virol. 67: 1759–1816.
34. Argoff CE. Review of current guidelines on the care of postherpetic neuralgia. Postgrad Med. 2011; 123(5): 134–42.
35. Baron R. Neuropathic pain: a clinical perspective. Handb Exp Pharmacol. 2009; 194: 3–30.
36. Naumann G, Gass JD, Font RL. Histopathology of herpes zoster ophthalmicus. Am J Ophthalmol 1968; 65: 533-41.
37. Burgoon CF, Burgoon JS, Baldridge GD. The natural
history of herpes zoster. JAMA 1957; 174: 265.
38. Gnann JW Jr, Whitley RJ. Clinical practice. Herpes zoster. N Engl J Med. 2002;347(5): 340–346.
39. Ramsay Hunt Syndrome [Internet]. NORD (National Organization for Rare Disorders). [cited 2020 Jul 31]. Available from: https://rarediseases.org/rare-diseases/ramsay-hunt-syndrome
40. Ramsay Hunt syndrome - Symptoms and causes [Internet]. Mayo Clinic. [cited 2020 Jul 31]. Available from: https://www.mayoclinic.org/diseases-conditions/ramsay-hunt-syndrome/symptoms-causes/syc-20351783
41. Ramsay Hunt Syndrome: Symptoms, Causes, and Recovery [Internet]. [cited 2020 Jul 31]. Available from: https://www.healthline.com/health/ramsay-hunt-syndrome
42. Hughes BA, Kimmel DW, Aksamit AJ. Herpes zoster-associated meningoencephalitis in patients with systemic cancer. Mayo Clin Proc. 1993; 68: 652–655.
43. Herpes zoster meningoencephalitis: not only a disease of the immunocompromised Douglas A, Harris P, Francis F, Norton R Infection. 2010 Feb; 38(1): 73-5.
44. Disseminated varicella-zoster virus in an immunocompetent adult. Petrun B, Williams V, Brice S Dermatol Online J. 2015 Feb 22; 21(3):.
45. Herpes Zoster - Infectious Diseases - MSD Manual Professional Edition [Internet]. [cited 2020 Jul 31]. Available from: https://www.msdmanuals.com/en-sg/professional/infectious diseases/herpesviruses/herpes-zoster
46. Jeon YH. Herpes zoster and postherpetic neuralgia: Practical consideration for prevention and treatment. Korean J Pain 2015; 28: 177-84.
47. Schmid DS, Jumaan AO. Impact of varicella vaccine on varicella-zoster virus dynamics. Clin Microbiol Rev 2010; 23:202-17.
48. O'Connor KM, Paauw DS. Herpes zoster. Med Clin North Am 2013; 97: 503-22, ix
49. Schmader K. Management of herpes zoster in elderly patients. Infect Dis Clin Pract. 1995; 4: 293–9.
50. Crooks RJ, Jones DA, Fiddian AP. Zoster-associated chronic pain: an overview of clinical trials with acyclovir. Scand J Infect Dis Suppl. 1991; 80: 62–8.
51. MacFarlane BV, Wright A, O'Callaghan J, Benson HA. Chronic neuropathic pain and its control by drugs. Pharmacol Ther. 1997; 75: 1–19.
52. Whitley RJ, Weiss H, Gnann J, Tyring S, Mertz GJ, Pappas PG, et al. Acylclovir with and without prednisone for the treatment of herpes zoster. A randomized, placebo-controlled trial. The National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. Ann Intern Med. 1996; 125: 376–83.
53. Neoh C, Harding SP, Saunders D, Wallis S, Tullo AB, Nylander A, et al. Comparison of topical and oral acyclovir in early herpes zoster ophthalmicus. Eye 1994; 8(Pt 6): 688-91