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Acta Paediatrica (Oslo, Norway : 1992) May 2022In previously healthy subjects, primary varicella presents with a distinctive vesicular rash that is more intense on the trunk and head than on the extremities. However,... (Review)
Review
AIM
In previously healthy subjects, primary varicella presents with a distinctive vesicular rash that is more intense on the trunk and head than on the extremities. However, an atypical presentation may occasionally develop. We aimed at systematically assessing the characteristics of cases affected by atypical primary varicella rash.
METHODS
The United States National Library of Medicine, Excerpta Medica and Web of Science databases were reviewed, without date or language restrictions. Articles were eligible if reporting previously healthy and immunocompetent subjects with a primary varicella rash (i.e., a photo-localised primary varicella or skin inflammation-associated primary varicella).
RESULTS
Thirty-eight reports providing information on 59 cases of atypical primary varicella were identified. Twenty-four cases (median 8.5 years of age, 19 females) were photo-localised and 35 (median 4.8 years of age, 15 females) were associated with pre-existing skin inflammation (including cast occlusion, diaper irritation, operative sites, burns, insect bites, vaccinations or pre-existing skin disease). The skin rash was monomorphic and without a "starry sky" appearance.
CONCLUSION
Primary varicella may have a modified presentation in areas of irritation such as sun exposure or pre-existing inflammation. There is a need for a wider awareness of these modulators of varicella rash.
Topics: Adolescent; Adult; Chickenpox; Exanthema; Female; Herpesvirus 3, Human; Humans; Inflammation; Skin; Young Adult
PubMed: 35178772
DOI: 10.1111/apa.16300 -
Sexually Transmitted Infections Apr 2005To explore epidemiological evidence about the interaction of herpes simplex virus (HSV) 1 and HSV-2 infections. (Review)
Review
OBJECTIVES
To explore epidemiological evidence about the interaction of herpes simplex virus (HSV) 1 and HSV-2 infections.
METHODS
A systematic review was undertaken of published epidemiological studies describing the pattern of HSV-1 or HSV-2 by age, and the coincidence of the two viral infections.
RESULTS
In cross sectional studies the unadjusted odds of HSV-2 are greater in those with HSV-1 infection in study populations categorised as "low risk" (p = 0.06) and across European populations (p = 0.001). This was not evident in "high risk" populations or in the United States. This increased risk of HSV-2 in those with HSV-1 infection does not agree with the results of prospective studies where there is a non-significant trend towards a lower risk of HSV-2 infection associated with previous HSV-1 infection.
CONCLUSIONS
"Low risk" and European populations have a relatively low HSV-2 seroprevalence and infection is more concentrated in those with characteristics putting them at high risk for both HSV-1 and HSV-2. This confounding could mask any protective effect of HSV-1, which is hinted at, but not demonstrated, in prospective and adjusted studies.
Topics: Herpes Simplex; Herpesvirus 1, Human; Herpesvirus 2, Human; Humans; Odds Ratio; Prevalence
PubMed: 15800084
DOI: 10.1136/sti.2004.012039 -
Expert Review of Vaccines May 2022Following COVID-19 vaccination, several herpes zoster cases have been reported, making it critical to explore the association between herpes zoster and COVID-19... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Following COVID-19 vaccination, several herpes zoster cases have been reported, making it critical to explore the association between herpes zoster and COVID-19 vaccination. This is especially true in the context of increasing the number of participants enrolled to receive COVID-19 vaccination.
RESEARCH DESIGN AND METHODS
Three databases, including the Cochrane Library, PubMed, and EMBASE, were searched for relevant studies before 25 December 2021 according to preliminarily determined inclusion and exclusion criteria without any language limitations. Four cohort studies were included in this systematic review and meta-analysis.
RESULTS
Compared with the placebo group, there was no evidence that the COVID-19 vaccination group was associated with increased incidence of herpes zoster (Risk ratio [RR]: 1.06; 95% confidence interval [CI]: 0.91 to 1.24). There is no evidence that the COVID-19 vaccination from Moderna is associated with the incidence of herpes zoster compared with vaccination from Pfizer (RR: 0.20; 95% CI: 0.01 to 2.99).
CONCLUSIONS
To date, there is no evidence of an association between covid-19 vaccination and herpes zoster.
Topics: COVID-19; COVID-19 Vaccines; Herpes Zoster; Herpes Zoster Vaccine; Herpesvirus 3, Human; Humans; Vaccination
PubMed: 35112938
DOI: 10.1080/14760584.2022.2036128 -
Journal of Oral Pathology & Medicine :... Sep 2017To evaluate the effectiveness and safety of nucleoside antiviral drugs for the treatment of recurrent herpes labialis. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To evaluate the effectiveness and safety of nucleoside antiviral drugs for the treatment of recurrent herpes labialis.
METHODS
Randomized controlled trials that examined the effectiveness and/or safety of nucleoside antiviral drugs for recurrent herpes labialis were identified via a literature search. The parameters used to measure efficacy were time to healing of classic and all lesions, time to resolution of pain, and percentage of aborted lesions. Safety was assessed by evaluating the adverse events reported during treatment. Subgroup analyses based on the mode of application (topical/systemic) and type of nucleoside antiviral drugs were performed, as were sensitivity analyses of studies with a low risk of bias.
RESULTS
Our analysis included 16 publications reporting 25 randomized controlled trials (8453 patients). Nucleoside antiviral drugs decreased the time to healing of all lesions (mean difference: -0.74 days; 95% confidence interval: -0.86, -0.62), especially classic lesions (mean difference: -1.09 days; 95% confidence interval: -1.27, -0.92). They also reduced the time to resolution of pain (mean difference: -0.38 days; 95% confidence interval: -0.58, -0.18) and increased the percentage of aborted lesions (rate ratio: 1.15; 95% confidence interval: 1.07, 1.23). Valaciclovir more effectively reduced the time to healing of all lesions and the time to resolution of pain than did aciclovir. Both nucleoside antiviral drugs increased the percentage of aborted lesions, whereas penciclovir and famciclovir did not.
CONCLUSIONS
Nucleoside antiviral drugs are safe and beneficial for the treatment of recurrent herpes labialis; both systemic and topical formulations are recommended. Valaciclovir is more effective than aciclovir, especially in reducing the time to healing of lesions.
Topics: Antiviral Agents; Herpes Labialis; Humans; Nucleosides; Recurrence; Simplexvirus
PubMed: 27935123
DOI: 10.1111/jop.12534 -
Phytotherapy Research : PTR May 2018Viral infections are being managed therapeutically through available antiviral regimens with unsatisfactory clinical outcomes. The refractory viral infections resistant... (Review)
Review
Viral infections are being managed therapeutically through available antiviral regimens with unsatisfactory clinical outcomes. The refractory viral infections resistant to available antiviral drugs are alarming threats and a serious health concern. For viral hepatitis, the interferon and vaccine therapies solely are not ultimate solutions due to recurrence of hepatitis C virus. Owing to the growing incidences of viral infections and especially of resistant viral strains, the available therapeutic modalities need to be improved, complemented with the discovery of novel antiviral agents to combat refractory viral infections. It is widely accepted that medicinal plant heritage is nature gifted, precious, and fueled with the valuable resources for treatment of metabolic and infectious disorders. The aims of this review are to assemble the facts and to conclude the therapeutic potential of medicinal plants in the eradication and management of various viral diseases such as influenza, human immunodeficiency virus (HIV), herpes simplex virus (HSV), hepatitis, and coxsackievirus infections, which have been proven in diverse clinical studies. The articles, published in the English language since 1982 to 2017, were included from Web of Science, Cochrane Library, AMED, CISCOM, EMBASE, MEDLINE, Scopus, and PubMed by using relevant keywords including plants possessing antiviral activity, the antiviral effects of plants, and plants used in viral disorders. The scientific literature mainly focusing on plant extracts and herbal products with therapeutic efficacies against experimental models of influenza, HIV, HSV, hepatitis, and coxsackievirus were included in the study. Pure compounds possessing antiviral activity were excluded, and plants possessing activity against viruses other than viruses in inclusion criteria were excluded. Hundreds of plant extracts with antiviral effect were recognized. However, the data from only 36 families investigated through in vitro and in vivo studies met the inclusion criteria of this review. The inferences from scientific literature review, focusing on potential therapeutic consequences of medicinal plants on experimental models of HIV, HSV, influenza, hepatitis, and coxsackievirus have ascertained the curative antiviral potential of plants. Fifty-four medicinal plants belonging to 36 different families having antiviral potential were documented. Out of 54 plants, 27 individually belong to particular plant families. On the basis of the work of several independent research groups, the therapeutic potential of medicinal plants against listed common viral diseases in the region has been proclaimed. In this context, the herbal formulations as alternative medicine may contribute to the eradication of complicated viral infection significantly. The current review consolidates the data of the various medicinal plants, those are Sambucus nigra, Caesalpinia pulcherrima, and Hypericum connatum, holding promising specific antiviral activities scientifically proven through studies on experimental animal models. Consequently, the original research addressing the development of novel nutraceuticals based on listed medicinal plants is highly recommended for the management of viral disorders.
Topics: Animals; Antiviral Agents; Coxsackievirus Infections; HIV; HIV Infections; Hepatitis; Herpes Simplex; Humans; Influenza, Human; Phytotherapy; Plant Extracts; Plants, Medicinal; Simplexvirus
PubMed: 29356205
DOI: 10.1002/ptr.6024 -
Clinical Infectious Diseases : An... Sep 2019The "exogenous boosting hypothesis" postulates that reexposure to circulating varicella zoster virus (VZV) over the life span inhibits reactivation of VZV. Consequently,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The "exogenous boosting hypothesis" postulates that reexposure to circulating varicella zoster virus (VZV) over the life span inhibits reactivation of VZV. Consequently, if circulation of VZV is suppressed by introduction of chickenpox vaccination, incidences of herpes zoster may rise.
METHODS
We performed a systematic review and metaanalysis on impact of chickenpox vaccination on herpes zoster incidence and time trend, focusing on population-level effects by analyzing interrupted time-series (ITS) studies. We searched Medline and Embase for ITS reporting incidences of chickenpox and herpes zoster before and after implementation of chickenpox vaccination. Autoregressive integrated moving average models were calculated. Change in trend and incidence from studies were pooled.
RESULTS
Twelve studies were included, of which 6 were eligible for metaanalysis. Metaanalysis revealed a significant increase in chickenpox cases prior to implementation of chickenpox vaccination and a reversed trend thereafter, particularly in individuals aged 1-4 years. The increase in age-adjusted herpes zoster incidence before implementation of chickenpox vaccination did not change thereafter. However, separate analysis of age groups revealed a net increase of hospitalized herpes zoster cases in individuals aged 10-49 years after implementation of chickenpox vaccination. This very small effect (fewer than 2 additional cases per 100 000 persons) did not occur in other age groups.
CONCLUSIONS
To date, no conclusive evidence exists that chickenpox vaccination has a substantial population-level impact on herpes zoster in nonvaccinated age groups. While exogenous boosting may exist, the effect size generated by chickenpox vaccination might be rather small on the population level.
Topics: Chickenpox; Chickenpox Vaccine; Herpes Zoster; Herpesvirus 3, Human; Humans; Incidence; Interrupted Time Series Analysis; Risk; Vaccination
PubMed: 30590491
DOI: 10.1093/cid/ciy1099 -
Vaccine Jan 2024In countries where varicella vaccination is not on the routine childhood immunisation schedule, such as those in the United Kingdom (UK), chickenpox is an almost... (Review)
Review
BACKGROUND
In countries where varicella vaccination is not on the routine childhood immunisation schedule, such as those in the United Kingdom (UK), chickenpox is an almost universal disease of childhood. Chickenpox can cause serious complications, particularly in infants, pregnant women, and the immunocompromised. In November 2023 the varicella vaccine was recommended for inclusion in the UK routine childhood immunisation schedule. Successful rollout of the vaccine may be hindered by parental concerns about vaccine safety and efficacy, and perceptions of chickenpox as a mild illness.
OBJECTIVE
To examine parental perceptions of chickenpox and varicella vaccination, which may be crucial to effective vaccination campaigns.
DESIGN
Qualitative systematic review and thematic analysis.
METHODS
Six electronic databases were systematically searched for studies published between 2016 and 2023: CINAHL, EMBASE, MEDLINE, PsycInfo, PubMed, and Web of Science. The included studies were appraised against the Critical Appraisal Skills Program checklist for qualitative studies. Thematic analysis was used to analyse qualitative data, through the development of themes.
RESULTS
22 articles were included in this review, and five themes identified: perceptions that chickenpox is a mild illness, that parents have concerns about varicella vaccine efficacy and safety, a notion of natural immunity as superior, social determinants of health influence vaccine decision making, and vaccination is overwhelming perceived as a parental decision.
CONCLUSIONS
Whilst some parents displayed an acceptance and willingness to vaccinate against chickenpox, many expressed concerns, and perceived chickenpox as a routine unworrying childhood illness. Analysis demonstrated a knowledge gap in understanding UK parental opinions regarding chickenpox and varicella vaccination, highlighting the need for research in this area, particularly given ongoing reconsideration for inclusion in the UK vaccination schedule.
REGISTRATION
The review was registered on PROSPERO, registration ID CRD42021236120.
Topics: Pregnancy; Infant; Humans; Female; Chickenpox Vaccine; Chickenpox; Herpesvirus 3, Human; Parents; Vaccination; Vaccines, Attenuated
PubMed: 38129287
DOI: 10.1016/j.vaccine.2023.12.045 -
JAMA Dec 2016Genital herpes simplex virus (HSV) infection is a prevalent sexually transmitted infection. Vertical transmission of HSV can lead to fetal morbidity and mortality. (Review)
Review
IMPORTANCE
Genital herpes simplex virus (HSV) infection is a prevalent sexually transmitted infection. Vertical transmission of HSV can lead to fetal morbidity and mortality.
OBJECTIVE
To assess the evidence on serologic screening and preventive interventions for genital HSV infection in asymptomatic adults and adolescents to support the US Preventive Services Task Force for an updated recommendation statement.
DATA SOURCES
MEDLINE, Cochrane Library, EMBASE, and trial registries through March 31, 2016. Surveillance for new evidence in targeted publications was conducted through October 31, 2016.
STUDY SELECTION
English-language randomized clinical trials (RCTs) comparing screening with no screening in persons without past or current symptoms of genital herpes; studies evaluating accuracy and harms of serologic screening tests for HSV-2; RCTs assessing preventive interventions in asymptomatic persons seropositive for HSV-2.
DATA EXTRACTION AND SYNTHESIS
Dual review of abstracts, full-text articles, and study quality; pooled sensitivities and specificities of screening tests using a hierarchical summary receiver operating characteristic curve analysis when at least 3 similar studies were available.
MAIN OUTCOMES AND MEASURES
Accuracy of screening tests, benefits of screening, harms of screening, reduction in genital herpes outbreaks.
RESULTS
A total of 17 studies (n = 9736 participants; range, 24-3290) in 19 publications were included. No RCTs compared screening with no screening. Most studies of the accuracy of screening tests were from populations with high HSV-2 prevalence (greater than 40% based on Western blot). Pooled estimates of sensitivity and specificity of the most commonly used test at the manufacturer's cutpoint were 99% (95% CI, 97%-100%) and 81% (95% CI, 68%-90%), respectively (10 studies; n = 6537). At higher cutpoints, pooled estimates were 95% (95% CI, 91%-97%) and 89% (95% CI, 82%-93%), respectively (7 studies; n = 5516). Use of this test at the manufacturer's cutpoint in a population of 100 000 with a prevalence of HSV-2 of 16% (the seroprevalence in US adults with unknown symptom status) would result in 15 840 true-positive results and 15 960 false-positive results (positive predictive value, 50%). Serologic screening for genital herpes was associated with psychosocial harms, including distress and anxiety related to positive test results. Four RCTs compared preventive medications with placebo, 2 in nonpregnant asymptomatic adults who were HSV-2 seropositive and 2 in HSV-2-serodiscordant couples. Results in both populations were heterogeneous and inconsistent.
CONCLUSIONS AND RELEVANCE
Serologic screening for genital herpes is associated with a high rate of false-positive test results and potential psychosocial harms. Evidence from RCTs does not establish whether preventive antiviral medication for asymptomatic HSV-2 infection has benefit.
Topics: Adolescent; Adult; False Positive Reactions; Female; Herpes Genitalis; Herpesvirus 2, Human; Humans; Male; Mass Screening; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Sensitivity and Specificity; Seroepidemiologic Studies
PubMed: 27997660
DOI: 10.1001/jama.2016.17138 -
Journal of Obstetrics and Gynaecology :... Jul 2016Varicella-zoster virus (VZV) is a teratogen that can cross the placenta and cause the congenital varicella syndrome (CVS), which is characterised by multi-system... (Review)
Review
Varicella-zoster virus (VZV) is a teratogen that can cross the placenta and cause the congenital varicella syndrome (CVS), which is characterised by multi-system anomalies. There have been 130 reported cases of CVS from 1947 to 2013. The estimated incidence of CVS was 0.59% and 0.84% for women infected with VZV during the entire pregnancy and for those infected the first 20 weeks of pregnancy, respectively. Nine cases were reported at 21-27 weeks of gestation and one case was identified at 36 weeks. Herpes zoster caused CVS in two cases. Regarding treatment, varicella zoster immunoglobulin treatment, irrespective of gestational age, should be considered in addition to antiviral drugs for women who have been exposed to or infected with virus.
Topics: Adult; Chickenpox; Female; Fetal Diseases; Gestational Age; Herpesvirus 3, Human; Humans; Incidence; Infant, Newborn; Infectious Disease Transmission, Vertical; Male; Pregnancy; Pregnancy Complications, Infectious; Syndrome
PubMed: 26965725
DOI: 10.3109/01443615.2015.1127905 -
Pathogens and Global Health Jul 2019A source of comprehensive information on the prevalence of herpes simplex virus type 1 and 2 (HSV-1 and HSV-2) can help researchers and policymakers address HSV related... (Meta-Analysis)
Meta-Analysis
A source of comprehensive information on the prevalence of herpes simplex virus type 1 and 2 (HSV-1 and HSV-2) can help researchers and policymakers address HSV related burden in the society. At the moment, this is not readily available. This study aims to fill this gap by attempting to estimate the seroprevalence of HSV-1 and HSV-2 infections in Nigeria on the basis of published data. A systematic review and meta-analysis including cross-sectional studies on HSV-1 and HSV-2 in Nigeria was conducted. Electronic databases including PubMed/MEDLINE, CENTRAL, African Journals Online (AJOL), ScienceDirect, WHO-Afro Library, WHO-IRIS and African Index Medicus were searched for English Language publications on HSV-1 and HSV-2. Seven relevant publications were identified. Seroprevalence measures of 3 and 23 for HSV-1 and HSV-2, respectively, were extracted. The pooled mean seroprevalences for HSV-1 and HSV-2 were 74.0% (37.4-99.4%) and 63.4% (56.1-70.4%) respectively. The mean seroprevalence of HSV-1 was higher among females, 82.4% (n = 509, CI, 36.6-100.0%), than males, 54.5% (n = 198, CI, 47.6-61.4%). The mean seroprevalence of HSV-2 were 51.8% (n = 1414, CI: 39.4-64.0%) and 86.5% (n = 162, CI: 80.8-91.3%) among healthy and clinical populations, respectively. The study was limited by the paucity of quality studies, variations in diagnostic methods and high heterogeneity in seroprevalence estimates. In conclusion, the seroprevalence of HSV-1 and HSV-2 remain high in Nigeria. Large and representative national epidemiological surveys covering all regions and specific groups are recommended.
Topics: Antibodies, Viral; Female; Herpes Simplex; Herpesvirus 1, Human; Herpesvirus 2, Human; Humans; Male; Nigeria; Seroepidemiologic Studies; Sex Factors
PubMed: 31645218
DOI: 10.1080/20477724.2019.1678938