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Human Vaccines & Immunotherapeutics Dec 2022This systematic review describes herpes zoster (HZ) economic burden in terms of healthcare resource use and cost outcomes in the Latin America and Caribbean (LAC)... (Meta-Analysis)
Meta-Analysis
This systematic review describes herpes zoster (HZ) economic burden in terms of healthcare resource use and cost outcomes in the Latin America and Caribbean (LAC) region. We searched online databases from 1 January 2000 to 20 February 2020 to identify eligible publications. We identified 23 publications that reported direct costs, indirect costs, and resources associated with HZ and its complications. The primary direct medical resources reported in the different studies were visits to doctors, transportation, days in the hospital, nursing, medication schedules, and physical therapy. Direct total costs per patient ranged from $99.99 to $4177.91. The highest cost was found in Brazil. Direct costs are, in average, 81.39% higher than indirect costs. The cost per patient that includes postherpetic neuralgia treatment is 115% higher on average for the directs and 73% for the indirect costs. Brazil reported a higher total cost per patient than Argentina and Mexico, while for indirect costs per patient, Brazil and Argentina had higher costs than Mexico, respectively. A meta-analysis on the number of days due to HZ hospitalization, performed on non-immunosuppressed patients over 65 years of age from three studies, resulted in a cumulative measure of 4.5 days of hospitalization. In the LAC region, the economic burden of HZ and associated complications is high, particularly among high-risk populations and older age groups. Preventative strategies such as vaccination could help avoid or reduce the HZ-associated disease economic burden in the LAC region.
Topics: Humans; Aged; Infant, Newborn; Latin America; Financial Stress; Herpes Zoster; Herpesvirus 3, Human; Neuralgia, Postherpetic
PubMed: 36519226
DOI: 10.1080/21645515.2022.2131167 -
Antiviral Research Apr 2017The optimal duration of prophylaxis for the varicella-zoster virus following hematopoietic stem cell transplantation (HSCT) remains unclear. The purpose of this study... (Meta-Analysis)
Meta-Analysis Review
The optimal duration of prophylaxis for the varicella-zoster virus following hematopoietic stem cell transplantation (HSCT) remains unclear. The purpose of this study was to systematically review the available literature to determine the optimal duration of antiviral prophylaxis for preventing herpes zoster (HZ) in allogeneic and autologous HSCT recipients. The MEDLINE and EMBASE databases were searched to identify relevant studies. The relative risk (RR) of HZ was calculated using fixed effects or random effects models depending on heterogeneity across the included studies. We analyzed six observational studies comprising a total of 3420 patients. In all HSCT recipients, the overall incidence of HZ in the prophylaxis group and the control group was 7.8% and 25.6%, respectively, with a pooled RR of 0.31 (95% CI, 0.26-0.37). The incidence of HZ in the subgroup wherein prophylaxis was given for at least 1 year and in the subgroup wherein prophylaxis was given for less than 1 year was 2.1% and 15.4%, respectively, with a pooled RR of 0.23 (95% CI, 0.04-1.39). Taken together, our results demonstrate that antiviral prophylaxis can significantly reduce HZ in HSCT recipients, and suggests that long-term prophylaxis given for at least 1 year may be recommended for better preventive effects.
Topics: Acyclovir; Antiviral Agents; Hematopoietic Stem Cell Transplantation; Herpes Zoster; Herpesvirus 3, Human; Humans; Observational Studies as Topic; Pre-Exposure Prophylaxis; Risk; Time Factors; Transplant Recipients; Valacyclovir; Valine; Virus Activation
PubMed: 28132866
DOI: 10.1016/j.antiviral.2017.01.011 -
Epidemiology and Infection Oct 2017Surveillance systems for varicella in Europe are highly heterogeneous or completely absent. We estimated the varicella incidence based on seroprevalence data, as these... (Review)
Review
Surveillance systems for varicella in Europe are highly heterogeneous or completely absent. We estimated the varicella incidence based on seroprevalence data, as these data are largely available and not biased by under-reporting or underascertainment. We conducted a systematic literature search for varicella serological data in Europe prior to introduction of universal varicella immunization. Age-specific serological data were pooled by country and serological profiles estimated using the catalytic model with piecewise constant force of infection. From the estimated profiles, we derived the annual incidence of varicella infection (/100·000) for six age groups (<5, 5-9, 10-14, 15-19, 20-39 and 40-65 years). In total, 43 studies from 16 countries were identified. By the age of 15 years, over 90% of the population has been infected by varicella in all countries except for Greece (86·6%) and Italy (85·3%). Substantial variability across countries exists in the age-specific annual incidence of varicella primary infection among the <5 years old (from 7052 to 16 122 per 100 000) and 5-9 years old (from 3292 to 11 798 per 100 000). The apparent validity and robustness of our estimates highlight the importance of serological data for the characterization of varicella epidemiology, even in the absence of sampling or assay standardization.
Topics: Age Factors; Chickenpox; Europe; Herpesvirus 3, Human; History, 20th Century; Humans; Immunization; Incidence; Seroepidemiologic Studies
PubMed: 28826422
DOI: 10.1017/S0950268817001546 -
Multiple Sclerosis and Related Disorders Aug 2021Although there has long been a suspected association between varicella-zoster virus (VZV) and multiple sclerosis (MS), the connection has remained unclear. In this... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Although there has long been a suspected association between varicella-zoster virus (VZV) and multiple sclerosis (MS), the connection has remained unclear. In this study, we performed a meta-analysis in an attempt to assess the association between VZV IgG serostatus and MS.
METHODS
A literature search was performed using three databases: MEDLINE, EMBASE, and Cochrane. Eligible results included observational studies investigating the seroprevalence of VZV immunoglobulin G (IgG) in adults with MS versus non-MS controls. Two authors performed a screen of the search results, evaluating them for quality and relevant outcomes. Using a random-effect model, we estimated pooled odds ratios (ORs) and 95% confidence intervals (CIs).
RESULTS
The literature search yielded 1,268 articles, 8 of which (2,266 MS patients and 1,818 controls) were eligible for inclusion in the meta-analysis. Evaluation of all included studies together showed no significant association between VZV IgG seropositivity and MS (OR 1.439; 95%CI, 0.503-4.118; p 0.497). However, when analyzed in subgroups based on geographical area, studies performed in Asian countries showed VZV IgG seropositivity was more common in MS patients than in controls (OR 4.470; 95%CI 1.959-10.203; p < 0.001). No significant association was found in European countries.
CONCLUSIONS
This study found evidence of an association between VZV IgG seropositivity and MS in Asian countries. Additional studies are warranted to ascertain factors impacting this association.
Topics: Adult; Antibodies, Viral; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunoglobulin G; Multiple Sclerosis; Seroepidemiologic Studies
PubMed: 34148006
DOI: 10.1016/j.msard.2021.103024 -
The Journal of Craniofacial SurgeryTo investigate the anatomical, pathogenetic, and pharmacological characteristics of herpes zoster ophthalmicus (HZO)- related ophthalmoplegia.
OBJECTIVE
To investigate the anatomical, pathogenetic, and pharmacological characteristics of herpes zoster ophthalmicus (HZO)- related ophthalmoplegia.
METHODS
Case report-based systematic review was performed.
RESULTS
This study included 96 patients (54 [56.25%] women and 42 [43.75%] men [P = 0.221]). The mean age at presentation was 64.32 ± 17.48 years. All the patients included in the study had HZO- related ophthalmoplegia, with rash presenting as initial symptom in 87 (90.62%) cases, and diplopia in 9 (9.38%) cases. Thirty-seven (38.54%) patients achieved complete recovery, whereas 59 (61.46%) patients had permanent ophthalmoplegia. Females recovered in 26/54 cases and males in 11/42 cases (P = 0.028). Recovery rates after peroral versus intravenous antivirals (15/38 versus 19/46) and > 10 days versus ≤10 days antiviral treatment (22/54 versus 12/30) did not significantly differ ( P = 0.865 and P = 0.947, respectively). immunocompetent patients treated with corticosteroids had significantly better recovery rates compared to immunodeficient counterparts (17/34 [50.00%] and 5/22 [22.73%], respectively [ P = 0.041]).
CONCLUSIONS
The outcome of HZO-related ophthalmoplegia is associated with gender, immune status, corticosteroid use, and time of antiviral treatment initiation.
Topics: Male; Humans; Female; Middle Aged; Aged; Aged, 80 and over; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Ophthalmoplegia; Antiviral Agents; Diplopia
PubMed: 35275867
DOI: 10.1097/SCS.0000000000008631 -
Journal of Veterinary Internal Medicine 2024Equine herpes virus type 1 (EHV-1) infection in horses is associated with upper respiratory disease, neurological disease, abortions, and neonatal death. (Review)
Review
BACKGROUND
Equine herpes virus type 1 (EHV-1) infection in horses is associated with upper respiratory disease, neurological disease, abortions, and neonatal death.
OBJECTIVE
To determine if there is an association between the level and duration of EHV-1 viremia and either abortion or equine herpesvirus myeloencephalopathy (EHM) in domesticated horses?
METHODS
A systematic review was performed searching numerous databases to identify peer reviewed reports that evaluated viremia and EHM, or viremia and abortion published before January 19, 2021. Randomized controlled trials and observational studies were assessed for risk of bias or publication quality.
RESULTS
A total of 189 unique studies were identified, of which 34 met the inclusion criteria. Thirty studies evaluated viremia and neurologic outcomes including 4 observational studies. Eight experimental studies examined viremia and abortion, which used the Ab4 and OH03 virus strains or recombinant Ab4 derivatives. Incidence rates for both EHM and abortion in experimental studies varied among the studies as did the level of evidence. Viremia was generally detectable before the onset of either EHM or abortion. Risk of bias was generally low to moderate, sample sizes were small, and multiple studies reported negative outcome data.
CONCLUSIONS AND CLINICAL IMPORTANCE
The results of this study support that viremia is regularly present before EHM or abortion occurs. However, no inferences could be made about the relationship between the occurrence of either neurological signs or abortion and the magnitude or duration of viremia.
Topics: Horses; Animals; Herpesvirus 1, Equid; Horse Diseases; Viremia; Herpesviridae Infections; Abortion, Veterinary; Female; Pregnancy
PubMed: 38069576
DOI: 10.1111/jvim.16948 -
Expert Review of Vaccines Apr 2017Varicella vaccines are highly effective at preventing disease, but varicella may occur among vaccinated persons (termed breakthrough varicella). Breakthrough varicella... (Review)
Review
Varicella vaccines are highly effective at preventing disease, but varicella may occur among vaccinated persons (termed breakthrough varicella). Breakthrough varicella is generally mild, but severe cases have been reported. The objective of this review is to describe severe breakthrough varicella. Areas covered: We conducted a systematic review of articles published during 1974-2016. A total of 34 articles were included in our review: 21 described breakthrough varicella with disseminated varicella-zoster virus (VZV) infection with other organ involvement in addition to skin (none among two-dose vaccinees); 9 described hospitalized breakthrough varicella without mention of other organ involvement in addition to skin (of which 2 reported 4 two-dose vaccinees); and 4 described both. A total of 52-60 unique breakthrough varicella cases with disseminated VZV infection with other organ involvement in addition to skin reported with the following complications, not mutually exclusive: pneumonia (n = 8-9 cases), neurologic (n = 18-24 cases), hematologic (n = 10-11 cases), ocular (n = 5 cases), renal (n = 2 cases), hepatic (n = 3 cases), secondary infection with bacteremia or sepsis (n = 8 cases), and other complication (n = 4 cases). There were 6 cases of fatal breakthrough varicella. Expert commentary: With >31 million doses distributed annually worldwide since 2007, severe breakthrough varicella can occur but they appear to be uncommon.
Topics: Chickenpox; Chickenpox Vaccine; Herpesvirus 3, Human; Humans
PubMed: 28276305
DOI: 10.1080/14760584.2017.1294069 -
Journal of Veterinary Internal Medicine 2024Equine herpes virus type 1 (EHV-1) infection in horses is associated with upper respiratory disease, neurological disease, abortions, and neonatal death. (Review)
Review
BACKGROUND
Equine herpes virus type 1 (EHV-1) infection in horses is associated with upper respiratory disease, neurological disease, abortions, and neonatal death.
REVIEW QUESTION
Does pharmacological therapy decrease either the incidence or severity of disease or infection caused by EHV-1 in domesticated horses?
METHODS
A systematic review was preformed searching AGRICOLA, CAB Abstracts, Cochrane, PubMed, Web of Science, and WHO Global Health Index Medicus Regional Databases to identify articles published before February 15, 2021. Selection criteria were original research reports published in peer reviewed journals, and studies investigating in vivo use of therapeutic agents for prevention or treatment of EHV-1 in horses. Outcomes assessed included measures related to clinical outcomes that reflect symptomatic EHV-1 infection or virus infection. We evaluated risk of bias and performed a GRADE evaluation of the quality of evidence for interventions.
RESULTS
A total of 7009 unique studies were identified, of which 9 met the inclusion criteria. Two studies evaluated valacyclovir or small interfering RNAs, and single studies evaluated the use of a Parapoxvirus ovis-based immunomodulator, human alpha interferon, an herbal supplement, a cytosine analog, and heparin. The level of evidence ranged between randomized controlled studies and observational trials. The risk of bias was moderate to high and sample sizes were small. Most studies reported either no benefit or minimal efficacy of the intervention tested.
CONCLUSIONS AND CLINICAL IMPORTANCE
Our review indicates minimal or limited benefit either as a prophylactic or post-exposure treatment for any of the studied interventions in the mitigation of EHV-1-associated disease outcome.
Topics: Animals; Horses; Herpesvirus 1, Equid; Horse Diseases; Herpesviridae Infections; Antiviral Agents; Valacyclovir
PubMed: 38380685
DOI: 10.1111/jvim.17016 -
Neurology India 2023Indian data regarding serious neurological and psychiatric adverse events, following coronavirus disease 2019 (COVID-19) vaccination, are lacking. We, therefore,...
Indian data regarding serious neurological and psychiatric adverse events, following coronavirus disease 2019 (COVID-19) vaccination, are lacking. We, therefore, systematically evaluated cases of post-vaccinal serious neurological and psychiatric adverse reactions published from India. A systematic review of cases published from India, which were archived in PubMed, Scopus, and Google Scholar databases, was performed; pre-print databases along with ahead-of-print contents were searched in addition. Retrieved articles, as on June 27, 2022, were evaluated following PRISMA guidelines. EndNote 20 web tool was used to make a PRISMA flow chart. Individual patients' data were compiled in a tabular form. The protocol of the systematic review was registered with PROSPERO (CRD42022324183). A total of 64 records describing 136 instances of serious neurological and psychiatric adverse events were identified. More than 50% (36/64) reports were from the following four states, namely, Kerala, Uttar Pradesh, New Delhi, and West Bengal. The mean age of persons developing these complications was 44.89 ± 15.77 years. In the majority, adverse events occurred within 2 weeks of administration of the first dose of COVISHIELD vaccine. Immune-mediated central nervous system (CNS) disorders were identified in 54 instances. Guillain-Barre syndrome and other immune-mediated peripheral neuropathies were reported in 21 cases. Post-vaccinal herpes zoster was recorded in 31 vaccine recipients. Psychiatric adverse events were recorded in six patients. In Indian recipients of COVID-19 vaccine, a variety of serious neurological complications were reported. The overall risk appears minuscule. Immune-mediated central and peripheral neuronal demyelinations were the most frequently reported post-vaccinal adverse events. A large number of cases of herpes zoster have also been reported. Immune-mediated disorders responded well to immunotherapy.
Topics: Adult; Humans; Middle Aged; ChAdOx1 nCoV-19; COVID-19; COVID-19 Vaccines; Guillain-Barre Syndrome; Herpes Zoster; Herpesvirus 3, Human; Peripheral Nervous System Diseases; Vaccines
PubMed: 37148041
DOI: 10.4103/0028-3886.375420 -
European Journal of Internal Medicine Oct 2022Varicella zoster virus (VZV) reactivation has been reported following vaccination for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the real extent...
INTRODUCTION
Varicella zoster virus (VZV) reactivation has been reported following vaccination for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the real extent remains unknown.
METHODS
We conducted a systematic review to summarize evidence of VZV reactivation or infection following SARS-CoV-2 vaccination. Episodes after coronavirus disease-2019 (COVID-19) were also identified. Related articles were identified in PubMed and EMBASE databases till December 31, 2021 using the terms "varicella zoster" and "COVID-19″. PROSPERO Register Number: CRD42021289399.
RESULTS
The search revealed 314 articles, of which 55 met the inclusion criteria. VZV manifestations were documented in 179 (82.1%) subjects following SARS-CoV-2 vaccination and in 39 (17.9%) patients with COVID-19. Among the vaccinated, median (IQR) age was 56.5 (42-70) years, and 56.8% were female. Twenty-one (16.8%) were immunosuppressed. The median (IQR) latency time after vaccination was 6 (3-10) days, and 84.4% received mRNA vaccines. VZV reactivation occurred following a first dose (68.2%), a second dose (12.8%) or a booster (0.6%). The most important VZV manifestation was dermatome herpes zoster rash, which accounted for 86.4% of events in vaccinated subjects. Twenty patients (11.3%) presented serious VZV events after vaccination, with Herpes Zoster ophthalmicus (5.6%) and post-herpetic neuralgia (3.4%) predominating. No VZV pneumonia or deaths were recorded. Antiviral prescriptions were made in 96.2% of vaccinated subjects. No significant differences between vaccinated and infected subjects were found.
CONCLUSION
This study indicates that the occurrence of VZV reactivation is clinically relevant. However, our findings suggest that COVID-19 vaccination is safe, and remains strongly recommended.
Topics: Aged; Antiviral Agents; COVID-19; COVID-19 Vaccines; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Male; Middle Aged; SARS-CoV-2; Vaccination
PubMed: 35931613
DOI: 10.1016/j.ejim.2022.07.022