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European Respiratory Review : An... Sep 2023Exacerbations of COPD are associated with worsening of the airflow obstruction, hospitalisation, reduced quality of life, disease progression and death. At least 70% of...
Exacerbations of COPD are associated with worsening of the airflow obstruction, hospitalisation, reduced quality of life, disease progression and death. At least 70% of COPD exacerbations are infectious in origin, with respiratory viruses identified in approximately 30% of cases. Despite long-standing recommendations to vaccinate patients with COPD, vaccination rates remain suboptimal in this population. is one of the leading morbidity and mortality causes of lower respiratory tract infections. The Food and Drug Administration recently approved pneumococcal conjugate vaccines that showed strong immunogenicity against all 20 included serotypes. Influenza is the second most common virus linked to severe acute exacerbations of COPD. The variable vaccine efficacy across virus subtypes and the impaired immune response are significant drawbacks in the influenza vaccination strategy. High-dose and adjuvant vaccines are new approaches to tackle these problems. Respiratory syncytial virus is another virus known to cause acute exacerbations of COPD. The vaccine candidate RSVPreF3 is the first authorised for the prevention of RSV in adults ≥60 years and might help to reduce acute exacerbations of COPD. The 2023 Global Initiative for Chronic Lung Disease report recommends zoster vaccination to protect against shingles for people with COPD over 50 years.
Topics: Humans; COVID-19; Herpesvirus 3, Human; Influenza Vaccines; Influenza, Human; Quality of Life; SARS-CoV-2; Streptococcus pneumoniae; United States; Vaccination; Whooping Cough; Middle Aged; Aged
PubMed: 37673427
DOI: 10.1183/16000617.0034-2023 -
BMJ (Clinical Research Ed.) Nov 2023To assess the effectiveness of live zoster vaccine during more than 10 years after vaccination; and to describe methods for ascertaining vaccine effectiveness in the...
OBJECTIVES
To assess the effectiveness of live zoster vaccine during more than 10 years after vaccination; and to describe methods for ascertaining vaccine effectiveness in the context of waning.
DESIGN
Real world cohort study using electronic health records.
SETTING
Kaiser Permanente Northern California, an integrated healthcare delivery system in the US, 1 January 2007 to 31 December 2018.
POPULATION
More than 1.5 million people aged 50 years and older followed for almost 9.4 million person years.
MAIN OUTCOME MEASURE
Vaccine effectiveness in preventing herpes zoster, postherpetic neuralgia, herpes zoster ophthalmicus, and admission to hospital for herpes zoster was assessed. Change in vaccine effectiveness by time since vaccination was examined using Cox regression with a calendar timeline. Time varying indicators were specified for each interval of time since vaccination (30 days to less than one year, one to less than two years, etc) and adjusted for covariates.
RESULTS
Of 1 505 647 people, 507 444 (34%) were vaccinated with live zoster vaccine. Among 75 135 incident herpes zoster cases, 4982 (7%) developed postherpetic neuralgia, 4439 (6%) had herpes zoster ophthalmicus, and 556 (0.7%) were admitted to hospital for herpes zoster. For each outcome, vaccine effectiveness was highest in the first year after vaccination and decreased substantially over time. Against herpes zoster, vaccine effectiveness waned from 67% (95% confidence interval 65% to 69%) in the first year to 15% (5% to 24%) after 10 years. Against postherpetic neuralgia, vaccine effectiveness waned from 83% (78% to 87%) to 41% (17% to 59%) after 10 years. Against herpes zoster ophthalmicus, vaccine effectiveness waned from 71% (63% to 76%) to 29% (18% to 39%) during five to less than eight years. Against admission to hospital for herpes zoster, vaccine effectiveness waned from 90% (67% to 97%) to 53% (25% to 70%) during five to less than eight years. Across all follow-up time, overall vaccine effectiveness was 46% (45% to 47%) against herpes zoster, 62% (59% to 65%) against postherpetic neuralgia, 45% (40% to 49%) against herpes zoster ophthalmicus, and 66% (55% to 74%) against admission to hospital for herpes zoster.
CONCLUSIONS
Live zoster vaccine was effective initially. Vaccine effectiveness waned substantially yet some protection remained 10 years after vaccination. After 10 years, protection was low against herpes zoster but higher against postherpetic neuralgia.
TRIAL REGISTRATION
ClinicalTrials.gov number NCT01600079; EU PAS register number EUPAS17502.
Topics: Humans; Middle Aged; Aged; Herpes Zoster Vaccine; Neuralgia, Postherpetic; Cohort Studies; Herpes Zoster Ophthalmicus; Electronic Health Records; Herpes Zoster; Herpesvirus 3, Human; Vaccination
PubMed: 37940142
DOI: 10.1136/bmj-2023-076321 -
Current Opinion in Ophthalmology Nov 2023This review broadly describes recent neuro-ophthalmic manifestations of varicella-zoster virus (VZV) reported in literature. (Review)
Review
PURPOSE OF REVIEW
This review broadly describes recent neuro-ophthalmic manifestations of varicella-zoster virus (VZV) reported in literature.
RECENT FINDINGS
Despite varicella vaccination, the incidence of herpes zoster continues to rise, potentially leading to devastating consequences when ocular complications occur.A small but growing literature documents cases of retinal disease because of varicella reactivation after SARS-CoV-2 vaccination, ischemic optic neuropathy occurring during herpes zoster ophthalmicus, VZV-induced orbital apex syndrome, and immune-mediated ocular complications in patients with prior neuro-ophthalmic manifestations of VZV.
SUMMARY
It is important for clinicians to keep abreast of the diverse neuro-ophthalmic manifestations of VZV as early diagnosis and treatment often lead to better visual outcomes.
Topics: Humans; Herpesvirus 3, Human; Chickenpox; COVID-19 Vaccines; COVID-19; SARS-CoV-2
PubMed: 37603549
DOI: 10.1097/ICU.0000000000000996 -
Neuroimaging Clinics of North America Feb 2024Stroke is a complication of many central nervous system (CNS) infections, but only a few present with stroke without other symptoms or signs of CNS infection. Chief... (Review)
Review
Stroke is a complication of many central nervous system (CNS) infections, but only a few present with stroke without other symptoms or signs of CNS infection. Chief among these are varicella zoster virus (VZV) and syphilis. Delayed cerebral vasculopathy after successful treatment of bacterial meningitis, most commonly pneumococcal, is an emerging entity with uncertain pathogenesis.
Topics: Humans; Herpes Zoster; Herpesvirus 3, Human; Stroke
PubMed: 37951699
DOI: 10.1016/j.nic.2023.06.001 -
Human Vaccines & Immunotherapeutics Dec 2023The recombinant zoster vaccine (RZV) was licensed in the US for prevention of herpes zoster (HZ) in 2017. We conducted a literature search (January 1, 2017-August 1,... (Review)
Review
The recombinant zoster vaccine (RZV) was licensed in the US for prevention of herpes zoster (HZ) in 2017. We conducted a literature search (January 1, 2017-August 1, 2023) using PubMed, Embase, and Scopus to consolidate the real-world evidence related to RZV. Overall, RZV effectiveness against HZ was high across the studied populations in real-world settings, including adults aged ≥ 50 years and patients aged ≥ 18 years with immunodeficiency or immunosuppression. Effectiveness was higher with two doses versus one dose, especially in elderly people and immunocompromised individuals. The safety profile of RZV was broadly consistent with that established in clinical trials. RZV does not appear to increase the risk of disease flares in patients with immune-mediated diseases. Approximately two-thirds of individuals received a second RZV dose within 2-6 months after the first dose. Collectively, RZV effectiveness against HZ was high, and these real-world studies reaffirm its favorable benefit-risk profile.
Topics: Aged; Humans; Herpes Zoster; Herpes Zoster Vaccine; Herpesvirus 3, Human; Immunocompromised Host; Vaccines, Synthetic; Adolescent; Adult; Middle Aged
PubMed: 37967254
DOI: 10.1080/21645515.2023.2263979 -
Graefe's Archive For Clinical and... Aug 2023While typically affecting older adults and immunocompromised individuals, herpes zoster ophthalmicus (HZO) has been reported with varying manifestations and... (Review)
Review
PURPOSE
While typically affecting older adults and immunocompromised individuals, herpes zoster ophthalmicus (HZO) has been reported with varying manifestations and complications in children. In this review, we evaluate reported cases of pediatric HZO in the literature and discuss the epidemiology, risk factors, clinical presentation, treatment and outcomes.
METHODS
A literature search on PubMed, Scopus, and Web of Science databases was performed using the terms "pediatric herpes zoster ophthalmicus" and "herpes zoster ophthalmicus children." Publications that were not specific to HZO or pediatric populations were excluded, as were publications that were not available to review or not published in the English language.
RESULTS
Fifty-seven reports describing 130 cases of HZO or HZO-related complications were reviewed. Major risk factors for pediatric HZO included intrauterine exposure to varicella or primary varicella infection at a young age; HZO also occurred in patients who had received varicella vaccination. Both healthy and immunocompromised children were affected, with the majority of affected children being immunocompetent. The diagnosis of HZO is primarily clinical. Children appear to have good vision recovery and resolution of symptoms if they are treated promptly and if they adhere to treatment regimens, except for irreversible vision loss related to uncommon complications such as optic neuritis.
CONCLUSION
HZO occurs in both healthy and immunocompromised children. Recognizing this treatable condition is essential for reducing ocular and systemic morbidity. Long-term follow-up and assessments of the impact on health in adulthood are lacking. More systematic study is needed to determine the incidence of HZO in children and appropriate diagnostic and treatment protocols for the care of pediatric patients with HZO.
Topics: Humans; Child; Aged; Herpes Zoster Ophthalmicus; Chickenpox; Herpesvirus 3, Human; Incidence; Morbidity
PubMed: 36949170
DOI: 10.1007/s00417-023-06033-0 -
Ocular Immunology and Inflammation Aug 2023To describe herpetic ocular infections following SARS-CoV-2 vaccinations. (Review)
Review
PURPOSE
To describe herpetic ocular infections following SARS-CoV-2 vaccinations.
METHODS
A retrospective study of herpetic ocular infections after BNT162b2mRNA vaccination and a literature review.
RESULTS
A cohort of five patients: three varicella zoster virus (VZV) and two herpes simplex virus (HSV) cases, as well as 19 literature cases: 9 cases of VZV and 10 cases of HSV post BNT162b2mRNA, AZD1222, mRNA-1273, and CoronaVac vaccinations. All cases presented within 28 days post vaccination. Most VZV and HSV cases (15/19) reported in the literature presented post first vaccine dose, while in our cohort 2 VZV cases presented post second dose and both HSV cases and one VZV case post third dose. The most common presentations were HZO with ocular involvement and HSV keratitis. All eyes had complete resolution; however, one had retinal detachment and three corneal scars.
CONCLUSION
Herpetic ocular infections may develop shortly after SARS-CoV-2 vaccinations. Overall, the outcome is good.
Topics: Humans; ChAdOx1 nCoV-19; COVID-19; COVID-19 Vaccines; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Keratitis, Herpetic; Retrospective Studies; SARS-CoV-2; Simplexvirus; Vaccination
PubMed: 35914308
DOI: 10.1080/09273948.2022.2103831 -
Current Protocols Jul 2023Our ability to understand the function of the nervous system is dependent upon defining the connections of its constituent neurons. Development of methods to define... (Review)
Review
Our ability to understand the function of the nervous system is dependent upon defining the connections of its constituent neurons. Development of methods to define connections within neural networks has always been a growth industry in the neurosciences. Transneuronal spread of neurotropic viruses currently represents the best means of defining synaptic connections within neural networks. The method exploits the ability of viruses to invade neurons, replicate, and spread through the intimate synaptic connections that enable communication among neurons. Since the method was first introduced in the 1970s, it has benefited from an increased understanding of the virus life cycle, the function of viral genomes, and the ability to manipulate the viral genome in support of directional spread of virus and the expression of transgenes. In this article, we review these advances in viral tracing technology and the ways in which they may be applied for functional dissection of neural networks. © 2023 The Authors. Current Protocols published by Wiley Periodicals LLC. Basic Protocol 1: Retrograde infection of CNS circuits by peripheral injection of virus Basic Protocol 2: Transneuronal analysis by intracerebral injection Alternate Protocol 1: Transneuronal analysis with multiple recombinant strains Alternate Protocol 2: Conditional replication and spread of PRV Alternate Protocol 3: Conditional reporters of PRV infection and spread Alternate Protocol 4: Reporters of neural activity in polysynaptic circuits Support Protocol 1: Growing and titering a PRV viral stock Support Protocol 2: Immunohistochemical processing and detection Support Protocol 3: Dual-immunofluorescence localization.
Topics: Animals; Herpesvirus 1, Suid; Neurons
PubMed: 37486157
DOI: 10.1002/cpz1.841 -
Atencion Primaria Oct 2023To review the latest published evidence on the vaccine used in our country against the herpes zoster virus, breaking down the results according to the efficacy,... (Observational Study)
Observational Study
OBJECTIVE
To review the latest published evidence on the vaccine used in our country against the herpes zoster virus, breaking down the results according to the efficacy, efficiency, effectiveness and safety of the vaccine. Include the current recommendations for vaccination.
DESIGN
Secondary review. Descriptive qualitative review. Review using the search term "herpes zoster vaccine" and "Adjuvanted recombinant Herpes Zoster subunit vaccine". Retrospective observational study.
DATA SOURCES
Embase, Medline and Google Scholar. Selection of studies Search criterion with the terms "Shingrix vaccine" and "Adjuvanted Herpes Zoster Subunit Vaccine". Search period 2013-2023. Studies classified as clinical trials or randomized clinical trials were selected. 21 published studies were evaluated. There were no exclusions.
RESULTS
The evaluated studies were found to be coherent and in all of them efficacy in adult individuals in preventing viral reactivation and in preventing complications was higher than 80%. The effectiveness of the vaccine after two doses was also higher than 80%. Cost-effectiveness studies were always favourable in adults, immunodepressed patients and individuals with chronic pathology. The safety of the vaccine was evaluated in the pivotal studies and in the post-commercialization studies that were undertaken (although there were few of the latter due to the short period of time studied). The safety profile of the vaccine is very high and in the case of severe adverse effects, their frequency was similar to that of a placebo.
CONCLUSIONS
We have a safe and effective vaccine against the herpes zoster virus that allows us to protect the most vulnerable population groups against this virus.
Topics: Adult; Humans; Herpesvirus 3, Human; Herpes Zoster; Herpes Zoster Vaccine; Vaccination; Vaccines, Subunit
PubMed: 37573820
DOI: 10.1016/j.aprim.2023.102710 -
Human Vaccines & Immunotherapeutics Dec 2023Herpes zoster (HZ) is a debilitating vaccine-preventable disease. Impairment of cell-mediated immunity, as observed with aging and immunosuppressive disorders and... (Review)
Review
Herpes zoster (HZ) is a debilitating vaccine-preventable disease. Impairment of cell-mediated immunity, as observed with aging and immunosuppressive disorders and therapies, increases risk. Recombinant zoster vaccine (RZV) is efficacious against HZ in adults aged ≥50 years in different settings, and in immunocompromised adults aged ≥18 years who are at increased risk of developing HZ. RZV is the first and only HZ vaccine approved for use in immunocompromised adults globally, including in Europe and the US. RZV has a clinically acceptable safety profile and elicits robust immune responses in adults aged ≥50 years, and in immunocompromised adults aged ≥18 years who are at increased risk of HZ. Additionally, RZV is efficacious against HZ complications such as post-herpetic neuralgia and HZ-related pain. This review updates knowledge from a randomized controlled trial setting on the efficacy, safety, immunogenicity, and impact on quality of life of RZV.
Topics: Adult; Humans; Adolescent; Herpes Zoster Vaccine; Quality of Life; Herpes Zoster; Neuralgia, Postherpetic; Herpesvirus 3, Human; Vaccines, Synthetic
PubMed: 37965770
DOI: 10.1080/21645515.2023.2278362